Pharmacy Service Representative Associate, Geisinger Health Plan (Eastern Standard Time resident)

Geisinger; Danville (PA); On-site; USD 38,000 - 52,000; Full time

Job summary

Geisinger in Danville, PA is seeking a Pharmacy Customer Service professional to assist leadership in processing provider and member prior authorization requests and to work with the pharmacy team in implementing policies to manage pharmacy benefits.

You will maintain policy understanding, provide high-level service to members and physicians, adhere to regulatory standards, and collaborate with pharmacists to resolve clinical issues in a timely fashion.

Qualifications

• Minimum 2 years of customer service experience.
• High School Diploma or GED is required.

Responsibilities

• Maintains understanding of all policies and procedures related to the pharmacy benefit.
• Provides the highest level of customer service and support to members and physicians.
• Adheres to all regulatory standards.
• Works with Pharmacists to resolve clinical issues with providers in a timely manner.
• Documents accurately all inquiries and prior authorization requests according to departmental policy.
• Determines appropriateness of pharmacy benefits under corresponding lines of business.
• Contacts providers and members to communicate the details of service, requests additional information and resolves outstanding matters.
• Updates current pharmacy benefits and serves as a facilitator to team members.

Skills

Customer Service

Education

High School Diploma or GED

Job description

Job Summary

Assists Pharmacy Customer Service leadership in processing provider, and member prior authorization requests. Works with the pharmacy team in implementing policies to manage pharmacy benefits.

Job Duties

Weekend and Holiday Coverage

• Maintains understanding of all policies and procedures related to the pharmacy benefit.
• Provides the highest level of customer service and support to members and physicians.
• Adheres to all regulatory standards.
• Works with Pharmacists to resolve clinical issues with providers in a timely manner.
• Documents accurately all inquiries and prior authorization requests according to departmental policy.
• Determines appropriateness of pharmacy benefits under corresponding lines of business.
• Contacts providers and members to communicate the details of service, requests additional information and resolves outstanding matters.
• Updates current pharmacy benefits and serves as a facilitator to team members.

Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.

Position Details

Education

High School Diploma or Equivalent (GED)- (Required)

Experience

Minimum of 2 years-Customer Service (Required)

Certification(s) and License(s)

OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.