PR-PHARMACY TECHNICIAN HELP DESK at TPIS

Bayamón, Puerto Rico, United States -

Full Time

Start Date

Immediate

Expiry Date

02 Apr, 26

Salary

0.0

Posted On

02 Jan, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Bilingual, Customer Service, Phone Skills, Written Communication, Active Listening, Attention to Detail, Time Management, Organizational Skills, Problem Solving, Research Skills, Software Proficiency, HIPAA Compliance, Pharmacy Knowledge, Claim Processing, Reimbursement Knowledge, Quality Management

Industry

Education Administration Programs

Description

POSITION SUMMARY The Pharmacy Help Desk Call Center Representative reports to the Pharmacy Help Desk Call Center Supervisor and is responsible to provide a customer service by telephone of incoming and outbound calls to providers, beneficiaries and pharmacies. ESSENTIALS ROLES AND RESPONSIBILITIES 1. Answer incoming pharmacy calls regarding issues related to a claim transaction, reimbursement, payment, and other required information in accordance with the Pharmacy Help Desk Call Center performance metrics. 2. Answer incoming providers’ and beneficiaries’ calls following Call Center scripts, in a timely matter and in accordance with the PBM call center performance metrics. 3. Answer incoming calls and perform outbound calls according to HIPAA and Pharmacy Laws Standards. 4. Identify pharmacies, providers and beneficiaries needs, clarify information, research every issue and providing solutions. 5. Document all inquiries in the Customer Service Management Applications such as, Service Desk, OneArk and email. 6. Route the case to the corresponding internal department or the appropriate Health Insurance Carrier. 7. Guide pharmacies, providers and beneficiaries regarding the process of claim transmission, reimbursement and payment. 8. Constantly monitors the BACMAN Alert Application to ensure proper management of rejections at point of sale. 9. 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. 10. Identify system issues and route to the corresponding internal department. 11. Make outbound calls to pharmacies, providers and beneficiaries if necessary. 12. Support all Quality Management Program initiatives. 13. Perform Special projects and/or other duties assigned by the Operations Manager and or Pharmacy Help Desk Call Center Supervisor. TRAINING & EDUCATION * Pharmacy Technician, Technical or Associate Degree LICENSURE / CERTIFICATION * Puerto Rico Board of Pharmacy Technician Registry Certificate (CPhT), or prospect. PROFESSIONAL EXPERIENCE * 1 - 2-year customer service or call center experience and healthcare environment (Preferable). PROFESSIONAL COMPETENCIES Knowledge: * Fully Bilingual (Spanish / English written and verbal). * PC skills (Microsoft System)/System oriented. Skills: * Strong customer service skills. * Excellent phone, written, active listening and follow-through skills. * Skill in analyzing situations accurately and taking effective action. * Attention to details. * 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. TPIS is an Equal Employment Opportunity Employer Minorities / Females / Disable / Veterans

Responsibilities

The Pharmacy Help Desk Call Center Representative is responsible for providing customer service via telephone to providers, beneficiaries, and pharmacies. This includes answering calls regarding claim transactions, reimbursement, and payment issues, while documenting inquiries and routing cases as necessary.