Pharmacy Benefits Specialist (Call Center)
Location: Altoona, WI
Job Type: FullTime, Hourly
The Pharmacy Benefits Specialist will be knowledgeable and participatory in numerous aspects of Pharmastar, a Pharmacy Benefits Manager (PBM) for commercial plans, Medicare Part D plans, and PACE plans. This position works with internal and external clients which include: members, clinicians, pharmacies, plan sponsors and other departments within the company.
- Answer telephone inquiries in a pleasant, professional and efficient manner assuring exceptional customer service.
- Communicate applicable drug benefit policies to all clients (members, pharmacies, plan administrators and clinicians).
- Document all incoming calls and dialogue in the claims adjudication software.
- Address and resolve client drug benefit concerns of a medical, financial, or technological nature.
- Initiate and facilitate prior authorization requests.
- Educate clients on plan policies and procedures.
- Stay current on plan and benefit structures, pharmacological updates, and Medicare Part D guidelines.
- Attend department and company meetings and educational programs upon request.
- Accept other duties as assigned; including but not limited to: direct member reimbursement, manual claims, reporting, enrollment activity, claims and pricing research.
- Previous experience as a pharmacy technician and/or certificate from an accredited pharmacy technician program, and/or 3-5 years of health insurance customer service experience.
- CPhT (Certified Pharmacy Technician) certification, or obtained within two years of initial employment date.
- Knowledge of pharmacology and pharmacological terms.
- Previous customer service experience required, call center experience preferred.
- 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.
- Computer skills including using word processors, spreadsheets, and database software.
This position offers an outstanding benefit package, including three weeks of PTO the first year, a generous retirement plan, health and dental insurance, a wellness program, and much more! If you are interested in working for an organization focused on a team atmosphere and dedicated to providing exceptional service submit your resume today!
How do I Apply?
To apply for the Pharmacy Benefits Specialist (Call Center) position, please send your resume and cover letter to the
director of Human Resources & Culture in an email to email@example.com.
Pharmastar and KMTSJ, Inc. are affirmative action and equal opportunity employers.