ExactCare

A national medication management and long-term pharmacy provider for people with complex, chronic needs

Pharmacy Claims Help Desk Specialist

Full TimeRemoteTeam 501-1,000Since 2009H1B No SponsorCompany SiteLinkedIn

Location

New Jersey

Posted

13 days ago

Salary

Not specified

Associate Degree1 yr expEnglish

Job Description

• 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 • Stay current on plan and benefit structures, pharmacological updates, and Medicare Part D guidelines • Participate in on-call rotation • Accept other duties as assigned; including but not limited to: direct member reimbursement, processing, manual claims, reporting and researching rejected claims • Attend department and company meetings and educational programs upon request • Ensures that HIPAA guidelines are followed in every communication with clients • Interest in learning new tasks for development purposes • Embody AnewHealth’s Core Values in all communications and interactions

Job Requirements

  • Associate’s degree preferred
  • High School Diploma or equivalent required
  • CPhT (Certified Pharmacy Technician) certification, a plus
  • 1 year of customer service/member service experience in a call center or similar, required
  • Health care industry experience, a plus
  • Experience in a pharmacy support role, a plus
  • Knowledge of plan and benefit structures and Medicare guidelines, a plus
  • Knowledge of pharmacology and pharmacological terms
  • Excellent communication skills and professionalism when working with clients
  • Ability to solve problems under pressure by making immediate decisions while on the phone
  • Detail oriented and able to prioritize workload
  • Strong computer skills including using word processors, spreadsheets, and database software

Benefits

  • Health insurance
  • 401(k)
  • Paid Time Off
  • Paid holidays
  • Flexible spending
  • Company-paid life insurance
  • Short-term disability
  • Voluntary benefits

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