Seeking for qualified Pharmacy Call Center Representative candidate to join our client as a regular employee. We are looking for successful people like you. Join the fastest growing Pharmacy Benefit Management (PBM) company in its category and take your professional career to the next level.
Position Summary
the Pharmacy Call Center Representative reports to the Pharmacy Call Center Supervisor and is responsible to provide a customer service by telephone of incoming and outbound calls to providers, beneficiaries and pharmacies.
Essential Roles and Responsibilities
Answer incoming pharmacy calls regarding issues related to a claim transaction, reimbursement, payment, and other required information in accordance with the client Pharmacy Call Center performance metrics.
Answer incoming providers and beneficiaries' calls following Call Center scripts, in a timely matter and in accordance with client call center performance metrics.
Answer incoming calls and perform outbound calls according to HIPAA and Pharmacy Laws Standards.
Identify pharmacies, providers and beneficiaries needs, clarify information, research every issue and providing solutions.
Document all inquiries in the Customer Service Management Applications such as, Service Desk, OneArk and email.
Route the case to the corresponding internal department or the appropriate Health Insurance Carrier.
Guide pharmacies, providers and beneficiaries regarding the process of claim transmission, reimbursement and payment.
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.
Identify system issues and route to the corresponding internal department.
Perform Special projects and/or other duties assigned by the Operations Manager and or Pharmacy Call Center Supervisor. .
Professional Experience and Skills Requirements
Pharmacy Technician, Technical or associate degree
Puerto Rico Board of Pharmacy Technician Registry Certificate (CPhT), (preferred).
One (1) or two (2) years of customer service or call center experience and healthcare environment, preferred.
Fully bilingual Spanish and English.
Proficiency in the use of Microsoft Tools: Excel, Word, Outlook, Office 365 and PowerPoint.
Additional Requirements:
The candidate must have:
100% of the Covid-19 Vaccine.
Must be able to work on site, Guaynabo.
TPIS is an Equal Employment Opportunity Employer Minorities / Females / Disable / Veterans
Job Type: Full-time
Pay: $13.50 per hour
Expected hours: 40 per week
Benefits:
401(k)
401(k) matching
Dental insurance
Free parking
Health insurance
Life insurance
Paid sick time
Paid time off
Retirement plan
Vision insurance
Physical Setting:
Call center
Schedule:
8 hour shift
Monday to Friday
Education:
Associate (Required)
Experience:
Pharmacy technician: 2 years (Required)
Language:
Bilingual (Required)
Work Location: In person