Pharmacy Benefits Coordinator

Johnson Service Group; Irvine (CA); A distancia; USD 30.000 - 42.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Weekly pay

Health insurance

Dental insurance

Vision insurance

401(k)

Descripción de la vacante

Johnson Service Group is seeking a Pharmacy Benefits Coordinator for the Pharmacy Insurance Team in Orange County. This is a remote opportunity with a Mon-Fri schedule and an hourly pay rate of $26.00.

The role requires experience in Pharmacy Benefit Management or retail pharmacy practice and may favor candidates with PTCB certification. Responsibilities include handling member inquiries about prescription benefits, processing Prior Authorization requests, training CSRs, and developing customer

Formación

• High school diploma and 1–3 years of experience in Pharmacy Benefit Management or retail pharmacy practice, preferred.
• PTCB certification (CBP) desirable.

Responsabilidades

• Respond to member questions about prescription drug benefits via telephone, email, and written correspondence in a confidential and professional manner.
• Assist Benefits Coordinator I & II with coordinating intake and processing Prior Authorization Requests between doctors, patients, and pharmacy.
• Provide support to CSRs to handle customer service inquiries.
• Assist in developing policies and procedures for customer service agents.
• Resolve escalations to meet Service Level Agreements in a timely manner.
• Responsible for the PBM customer service Help Desk daily tasks and communications.
• Develop client-facing reporting and communications with stakeholders.
• Implement and uphold "white glove" PBM customer service expectations.

Conocimientos

PBM knowledge

Customer service

Phone & email support

Prior Authorization

English fluent

Spanish preferred

Time management

Communication skills

Educación

High school diploma

1–3 years PBM or retail experience

Descripción del empleo

Johnson Service Group is seeking a Pharmacy Benefits Coordinator for the Pharmacy Insurance Team in Orange County. This is a remote opportunity. Work Schedule: Mon-Friday; 7:30am- 4:30pm PST or 9:00am- 5:30pm PST. Hourly Pay: $26.00 per hour.

QUALIFICATIONS

• High school diploma and one (1) to three (3) years of experience in Pharmacy Benefit Management or retail pharmacy practice, preferred.
• Valid Pharmacy Technician Certification Board Certification (PTCB), desirable.
• Intermediate knowledge of prescription benefits and products, and pharmacy claims.
• Patient Care oriented with ability to set priorities and meet required turn-a-round time frames.
• Excellent written and oral communication skills, as well as interpersonal skills.
• Good skills for project-based tasks.
• Ability to work effectively in a fast-paced environment
• Analytical thinking skills and problem-solving capabilities.
• Good communication and telephone skills
• Ability to adapt to a constantly changing environment.
• Proficient organizational and time management skills.
• Fluent in English (oral and written) required.
• Bilingual in Spanish preferred.

DUTIES AND RESPONSIBILITIES

Customer Service

• Ability to respond to a wide-variety of member questions via telephone, email and written correspondence regarding prescription drug benefits in a confidential, professional and ethical manner such as confirming Prior authorization status, verifying patient eligibility & pharmacy benefits, and placing overrides for rejected pharmacy prescription claims.
• Assist Benefits Coordinator I & II with coordinating intake and processing Prior Authorization Requests between doctors, patients, and pharmacy.
• Provide support to Benefits Coordinator II with training CSRs to handle customer service inquiries.
• Assist the Benefits Coordinator II in developing policies and procedures for our customer service agents.
• Provide assistance to Benefits Coordinator I & II and Supervisor in resolving all escalations in a timely manner to meet our Service Level Agreements.
• Responsible for the PBM customer service Help Desk for day-to-day tasks. Prior Authorization tickets, after hours voicemails/ emails, customer service emails, and direct member reimbursements.
• Provide the Benefit I coordinator support to develop client-facing reporting and communications.
• Responsible for implementing "white glove" customer service expectations for the PBM.

Operations

• Achieve service level targets with our email box, Prior Authorization tickets, organizing documents in the H drive, and other areas of pharmacy operations.
• Utilize creative methods to understand how our customers perceive their interactions with Pinnacle Rx Solutions and the process for getting their medications.
• Provide suggestions and contribute to workflow improvements.
• Contribute to team of highly skilled and talented experts who maintain the current reporting environment and work to continually improve it by delivering operational reporting products, including critical metric reporting, performance dashboards, work-in-progress trackers and forecasting.
• Back-up and assist the Benefits Coordinator I & II in performing process Improvements, reporting and analytics, project management, and quality assurance activities.

Other

• Utilize all capabilities to satisfy one mission - to enhance the competitiveness and profitability of our members. Do everything possible to help members succeed by being curious and striving to understand what others are trying to achieve, planning, and executing work helpfully and collaboratively. Be willing to adjust efforts to ensure that work and attitude are helpful to others, being self-accountable, creating a positive impact, and being diligent in delivering results.
• Focus efforts on quality and quantity of product deliverables as well as resourcing and project management in a fast paced and challenging environment.
• Ensure application compliance while creating an environment for innovation and growth.
• Maintain internet speed of 40 MB download and 20 MB upload and router with wired Ethernet. Home router with wired Ethernet (wireless connections and hotspots are not permitted).
• Other duties as assigned.

JSG offers medical, dental, vision, life insurance options, short-term disability, 401(k), weekly pay, and more.

Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law. #D800