Customer Support Specialist
United StatesFull-TimeMiddle
Salary not disclosed
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Job Details
- Experience
- 3 years of experience in customer service/member service in a call center or similar; 2 years of experience in the healthcare industry; 2 years of experience in a pharmacy support role.
- Required Skills
- JiraMicrosoft ExcelHIPAA
Requirements
- Associate’s degree or equivalent combination of education or work experience.
- 3 years of experience in customer service/member service in a call center or similar.
- 2 years of experience in the healthcare industry.
- 2 years of experience in a pharmacy support role.
- Knowledge of plan and benefit structures and Medicare guidelines.
- Knowledge of pharmacology and pharmacological terms.
- Excellent communication skills and professionalism.
- Ability to solve problems under pressure.
- Strong computer skills including word processors, spreadsheets, and database software.
- Detail oriented and able to prioritize workload.
Responsibilities
- Answer telephone inquiries in a pleasant, professional, and efficient manner assuring exceptional customer service.
- Document all incoming calls and dialogue in the claims adjudication software.
- Educate clients on plan policies, benefits, and procedures.
- Resolve client drug benefit concerns of a medical, financial, or technological nature.
- Initiate and facilitate prior authorization requests.
- Make outbound calls to pharmacies and plans to facilitate completion of JIRA tickets.
- Review after hours calls log-complete any follow up as needed.
- Submit JIRA tickets for compound prescriptions and NDC issues.
- Stay current on plan and benefit structures, pharmacological updates, and Medicare Part D guidelines.
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