Rx Customer Service Specialist

Abarca Health

Customer Service & Support

Healthcare Confidential
1 month ago

Job Summary

As the Rx Customer Service Specialist, you will serve at the front line of all incoming and outgoing communication (calls, emails, and faxes) with pharmacies, beneficiaries, and prescribers. You will use Rx Platform and other resources as necessary to resolve caller’s needs.

  • Minimum Qualification:Degree
  • Experience Level:Entry level
  • Experience Length:1 year

Job Description/Requirements

The fundamentals for the job… 

  • Manage all incoming calls, emails, faxes and web-generated requests from pharmacies, beneficiaries, and prescribers.
  • Provide service-level standards set by CMS or by client; 80% of calls should fall within service level, less than 5% abandon rate and speed to answer should be less than 30 seconds.
  • Rejection support, including overrides.
  • Provide Coverage Determination status to clients including exceptions and appeals.
  • Administrative PAs- Document PA request inquiries, issues, status, and resolution in accordance with federal and department and company policies and guidelines.
  • Answer questions and recommend corrective services to address customer complaints, payment status, manual reversal requests, benefit and eligibility support, provider portal support and response to price appeals.
  • Report identified issues to the appropriate department, for investigation and correction, following the established procedure.

What you’re made of

The bold requirements…

  • Pharmacy Technician Associate Degree preferred (In lieu of a degree, equivalent relevant work experience may be considered.)  
  • 1+ years of experience working in a Pharmacy or Member Services Call Center, Retail or Hospital Pharmacy Setting.
  • Active Pharmacy Technician License.
  • Excellent oral and written communication skills.

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