Pharmacy Benefit Specialist - Onsite/In Office

A LARGE BENEFITS AND HEALTH PLAN PROVIDER WITHIN EITHER THE MURRAY, UT OR LAS VEGAS, NV AREA IS LOOKING TO HIRE ON A HANDFUL OF PHARMACY BENEFITS SPECIALISTS TO JOIN THEIR TEAM!

Pay: $21/hr

Start Date: 7/7

Schedule:

6-week Training

Mon-Fri 8-4:30pm MST or 7am-3:30pm PST

8-Hour Shift anytime between 8am-9pm MST or 7am-8pm PST so shifts may vary

1 Rotating Saturday every 4-5 weeks depending on business needs

After 1-year can shift to a hybrid/remote setting

Highlight:

• Industry: Customer Service, Data Entry and Benefits Advisory/Support
• Employment Type: 4 Month Contract-To-Hire (Long-Term)
• Location: Murray, UT & Las Vegas, NV

Job Essentials:

• Processes and/or communicates multiple types of pharmacy benefits including coordination of benefits, direct member reimbursements, coinsurance benefits, and mail order prescriptions.
• Receives incoming calls from members, providers, facilities, employer groups, and other departments. Provides superior customer service that is consistent with policies, company values, and quality standards.
• Educates callers on correct use of their plans, including coverage of benefits, utilization, and administrative guidelines, in collaboration with teammates and other departments. Makes exception / empowerment decisions within the established exception policy.
• Consistently demonstrates excellent customer service skills including problem solving, telephone etiquette, and responsiveness to customers.
• Ensures that all department phone standards and expectations are met pertaining to call statistics, production, documentation, and quality/accuracy.
• Efficiently and quickly addresses and solves problems on phone calls.
• Acts as a resource to all Pharmacy Benefit Specialist I employees for policy inquiries, questions, and problems that arise. Acts as a mentor and willingly coaches and develops others under the direction of the team supervisor and trainer, and provides effective feedback to other Pharmacy Benefits Specialists as needed.
• Meets or exceeds department standard for call time and answered call percentage in relation to the team average.
• Efficiently and accurately enter overrides for pharmacy claims. Meets or exceeds department standards for override audits.
• When assigned, assists in the payment of claims for both members and pharmacies while maintaining accuracy standards.
• Completes and analyzes specialized reports that are used to ensure timely and accurate claims adjudication.
• Works closely with the operation and pharmacy teams to educate the staff and resolve problems.
• Maintains the confidentiality of member's personal information to be compliant with internal confidentiality policy. Maintains customer history in member tracking using correct codes and detailed comments.

Additional Skills & Qualifications:

• Demonstrated ability to provide superior customer service
• Demonstrated ability to listen and communicate effectively
• Demonstrated ability to problem solve and work under pressure
• Demonstrated proficiency in navigating computer systems, typing, and technologies
• Demonstrated experience mentoring or training on pharmacy or government benefits