Chronic Care Pharmacy-at-Home • Medication Management for High-Risk Patients • Medication Therapy Management • Gaps in Care • STAR Ratings Adherence Improvement
501 - 1000 employees
Founded 2009
⚕️ Healthcare Insurance
💊 Pharmaceuticals
💰 Private Equity Round on 2016-03
3 days ago
Chronic Care Pharmacy-at-Home • Medication Management for High-Risk Patients • Medication Therapy Management • Gaps in Care • STAR Ratings Adherence Improvement
501 - 1000 employees
Founded 2009
⚕️ Healthcare Insurance
💊 Pharmaceuticals
💰 Private Equity Round on 2016-03
• Answer telephone inquiries in a pleasant, professional and efficient manner assuring exceptional customer service. • Document all incoming calls and dialogue in the claims adjudication software. • Educate clients on plan policies, benefits and procedures. • Resolve client drug benefit concerns of a medical, financial, or technological nature. • Initiate and facilitate prior authorization requests. • Stay current on plan and benefit structures, pharmacological updates, and Medicare Part D guidelines. • Participate in on-call rotation. • Accept other duties as assigned; including but not limited to: direct member reimbursement, processing, manual claims, reporting and researching rejected claims. • Attend department and company meetings and educational programs upon request. • Ensures that HIPAA guidelines are followed in every communication with clients. • Interest in learning new tasks for development purposes.
• Associate’s degree preferred. • High School Diploma or equivalent required. • 1 year of customer service/member service experience in a call center or similar, required. • Health care industry experience, a plus. • CPhT (Certified Pharmacy Technician) certification, a plus. • Experience in a pharmacy support role, a plus. • Knowledge of plan and benefit structures and Medicare guidelines, a plus.
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