Pharmacy Call Center Representative Job at PharmPix Corp in Guaynabo
PharmPix Corp, Guaynabo, PR, United States, 00965
Overview
Join to apply for the Pharmacy Call Center Representative role at PharmPix Corp.
About the Company
PharmPix is a state-of-the-art pharmacy benefits information and management provider that saves your company costs by giving you back the power of decision. We offer innovative services for health plans and insurers, medium to large employers and union groups, private and government health programs, including Medicaid and Medicare. We pride ourselves in being super flexible, supporting any number of arrangements with our clients: from traditional third-party full pharmacy benefit management (PBM) service contracts to applications licensing agreements. We are virtual full service PBM with an adaptable business model for different pharmacy delivery solutions. PharmPix offers an innovative technology platform that effectively allows you to manage your pharmacy benefit costs: the OneArk Suite. Our technology platform serves the ever-changing needs of health insurance industry professionals. It is powerful, simple and cost-effective; setting a new standard in clinical intelligence technology. OneArk Suite also helps you grow a deeper connection to your beneficiaries and providers.
About the Role
The Pharmacy Help Desk Call Center Representative is responsible to provide a customer service by telephone of incoming and outbound calls to providers, beneficiaries and pharmacies.
Responsibilities
- Answer incoming pharmacy calls regarding issues related to a claim transaction, reimbursement, payment, and other required information in accordance with PharmPix Pharmacy Help Desk Call Center performance metrics.
- Answer incoming providers and beneficiaries’ calls following Call Center scripts, in a timely matter and in accordance with PharmPix call center performance metrics.
- Answer incoming calls and perform outbound calls according to HIPAA and Pharmacy Laws Standards.
- Identify pharmacies, providers and beneficiaries needs, clarify information, research every issue and providing solutions.
- Document all inquiries in the Customer Service Management Applications such as, Service Desk, OneArk and email.
- Route the case to the corresponding internal department or the appropriate Health Insurance Carrier.
- Guide pharmacies, providers and beneficiaries regarding the process of claim transmission, reimbursement and payment.
- Constantly monitors the BACMAN Alert Application to ensure proper management of rejections at point of sale.
- Evaluate on an individual basis to determine if the patient meets the criteria for a coverage determination for alerts such as DURs (Drug Utilization Reviews), HMO (Health Maintenance Organization) among other rejections evaluations required by business.
- Identify system issues and route to the corresponding internal department.
- Make outbound calls to pharmacies, providers and beneficiaries if necessary.
- Support all Quality Management Program initiatives.
- Perform Special projects and/or other duties assigned by the Operations Manager and or Pharmacy Help Desk Call Center Supervisor.
Qualifications
- Pharmacy Technician, Technical or Associate Degree
- Puerto Rico Board of Pharmacy Technician Registry Certificate (CPhT), or prospect.
- 1 - 2-year customer service or call center experience and healthcare environment (Preferable).
Skills
- Excellent phone, written, active listening and follow-through skills.
- Skill in analyzing situations accurately and taking effective action.
- Time Management Skills: Establishing priorities and accomplishing tasks in a timely manner.
- Ability to work with others to reach a solution.
- Be able to toggle between several software programs.
- Demonstrated effective organizational skills.
Knowledge
- Fully Bilingual (Spanish / English written and verbal).
- PC skills (Microsoft System)/System oriented.
Abilities
- Able to effectively interact with internal departments, PharmPix clients, members and other healthcare professionals.
- Ability to work with others to reach a solution.
- Be able to toggle between several software programs.
- Ability to work in a fast-paced environment and multitask.
EEO Statement
PharmPix is an Equal Employment Opportunity Employer Minorities / Females / Disable / Veterans
Job Details
- Seniority level: Entry level
- Employment type: Full-time
- Job function: Health Care Provider
- Industries: Health and Human Services