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Pharmacy Resolution Specialist
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Job Description
- Req#: 1623831
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Salary up to $27.25 per hour
- Comprehensive benefits package including health insurance, 401K, and stock purchase plans
- Tuition reimbursement and paid time off plus holidays
- Flexible work arrangements available: remote, hybrid, field, or office schedules
- Opportunity to make a significant impact on member satisfaction and health outcomes
What to Expect (Job Responsibilities):
- Receive and respond to calls from members, providers, and pharmacies regarding benefit inquiries and prior authorization requests
- Research issues thoroughly and take appropriate actions to resolve them while adhering to turnaround time requirements and quality standards
- Log, track, and resolve all assigned inquiries and complaints in compliance with regulatory and corporate guidelines
- Maintain expert knowledge of pharmacy benefits and formularies, including relevant CMS regulations
- Assist with special projects and perform other duties as assigned
What is Required (Qualifications):
- High School Diploma or GED
- Minimum of 1 year of experience in a job-specific call center or customer service role
- Strong attention to detail and ability to ensure first call resolution
- Excellent verbal communication skills for conducting inbound and outbound calls
- Ability to interpret pharmacy and medical benefits accurately
How to Stand Out (Preferred Qualifications):
- Experience in the healthcare industry or pharmacy-related field
- Knowledge of CMS regulations and pharmacy benefits
- Proficiency in using call center management software
- Strong problem-solving skills and ability to identify root cause issues
#HealthcareServices #Pharmacy #CustomerService #CareerOpportunity #FlexibleWork
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