Location: St. Louis, MO
Description: Temporary Remote -Pharmacy Tech I - St Louis Market
Schedule:
May be scheduled anytime Monday through Friday from 7:00am CST to 10:pm CST; Saturday and Sunday 9:00am -5:00pm CST
Job Summary:
Responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. Must pass the appropriate pre-employment test battery.
Primary duties may include, but are not limited to:
Responds to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims.
Analyzes problems and provides information/solutions.
Operates a PC/image station to obtain and extract information; documents information, activities and changes in the database.
Thoroughly documents inquiry outcomes for accurate tracking and analysis.
Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
Researches and analyzes data to address operational challenges and customer service issues. Provides external and internal customers with requested information.
Under immediate supervision, receives and places follow-up telephone calls / e-mails to answer customer questions that are routine in nature.
Uses computerized systems for tracking, information gathering and troubleshooting. Requires limited knowledge of company services, products, insurance benefits, provider contracts and claims. Seeks, understands and responds to the needs and expectations of internal and external customers. Required to meet department goals. Requires a HS diploma or equivalent; up to 1 year of previous experience in an automated customer service environment; or any combination of education and experience, which would provide an equivalent background.
Verifies member information and inputs data for the pharmacists.
Educates members on pharmacy based rules related to prescriptions and medication resources or assistance programs.
Processes prior authorization requests from physicians offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations.
Provides resolution to grievances and appeals issues.
Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits.
Generates reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports.
Maintains record keeping of prior authorizations, rebates, and monthly reports.
Education:
Requires a high school diploma; 1 year of pharmacy experience; or any combination of education and experience, which would provide an equivalent background.
Licensing and Certification:
Current State Pharmacy Tech. Certification or National Certification based on applicable state(s) required.
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