Pharmacy Help Desk Call Center Representative

Responsibilities: Answering Incoming Calls: Respond to incoming calls from pharmacies, providers, and beneficiaries about claims, reimbursements, payments, and other inquiries.
Resolving Inquiries: Find and address the needs of callers, providing accurate information and solutions to their problems.
Documenting Interactions: Record all inquiries and resolutions in relevant customer service management systems
Routing Issues: Forward complex or specialized issues to the right internal departments or external organizations.
Providing Guidance: Offer guidance on claim submission, reimbursement processes, and payment inquiries.
Monitoring System Alerts
Evaluating Coverage Criteria: Assess patient eligibility for coverage based on specific criteria and regulations. (DURs (Drug Utilization Reviews), HMO (Health Maintenance Organization)
Supporting Quality Initiatives
Requisitos:
Strong computer skills:, MS Office Suite and other relevant software.
Bilingual - Fluency in both Spanish and English, both written and spoken.
1 - 2-year customer service or call center experience in healthcare environment (Preferable).
Excellent interpersonal and communication skills, including active listening and empathy.
Ability to analyze problems, find solutions, and take the right action.
Effective time management and prioritization skills.
Ability to stay organized and manage multiple tasks efficiently.
Ability to adapt to changing situations and work in a fast-paced environment.

Education:
Pharmacy Technician, Technical or associate degree
Puerto Rico Board of Pharmacy Technician Registry Certificate (CPhT), or prospect.