Hours: Must be available to work between 1pm-12am; 8 hour shift
--Serve as initial point of contact to all incoming patient profiling, medication updates by pharmacies, nurses and other healthcare provider.
--Utilize multi-media functions (phone calls, faxes, and e-mail and integration files) to accurately input patient profile eligibility, medical history, clinical data, and updates into company operation platforms.
--Assist pharmacies in claims processing by providing information needed to process claims and researches all information related to pharmacy rejections.
--Process medication overrides for dosage changes or RTS (refills too soon), etc.
--Input manual claim data into the database on claims outside of processing window.
--Input appropriate claim processing call tracking notes with each call received.
--Provide patient medication profiles to facility pharmacies.
--Troubleshoot and resolve pharmacy related issues for Client Services.
--Input appropriate call-tracking notes with each call, fax, e-mail, or integration received.
--Transfer HospiOnDemand clients to clinical pharmacists for consults and create work order tickets and consult notes for pharmacist request.
--Assign coverage, transfers patients, or trouble shoots rejections as directed by clinical pharmacists.
--Work all assigned discharges and censuses from the Discharge Data Base.
Working hours: 1:00 PM - 12:00 AM
--Knowledge of proper telephone etiquette; previous call center experience preferred.
--Must have attention to detail with excellent problem solving and multi-tasking skills
--Computer literacy / data entry skills are required and proficiency in Microsoft Word, Outlook, and Excel
--Excellent written and verbal communication skills are required.
--Experience with image display software and web-based data entry software.
--Knowledge of Medical Terminology and ICD-10 Codes preferred.
--Knowledge of drug therapies. (Generic/Brand names, drug classes, sigs)
--Basic math and analytical skills.
--Possess a positive attitude and strong work ethic.
--Ability to work in a team environment and promote teamwork.
--Need to be able to work a flexible schedule including nights and weekends.
Education and Experience
--Previous pharmacy technician experience highly desired, certification or licensure highly desired and/or related PBM business experience with knowledge of long term care pharmacy billing.
--Must have a High School diploma or equivalent. College or technical training a plus.
Please send resume to email@example.comHelp
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