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

Geisinger Health; Danville (PA); Remote; USD 36,000 - 48,000; Full time

Job summary

Geisinger Health seeks a Pharmacy Customer Service support role to assist leadership in processing provider and member prior authorization requests. You will collaborate with the pharmacy team to implement policies and manage pharmacy benefits from a work-from-home position based in Pennsylvania.

Applicants should have at least 2 years of customer service experience, with strong communication and a focus on excellent member and physician service.

Qualifications

• High School Diploma or Equivalent (GED) required.
• Minimum of 2 years of Customer Service experience required.
• Strong communication and customer service skills.

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.
• 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 details of service and requests for additional information.
• Updates current pharmacy benefits and serves as a facilitator to team members.

Skills

Communication

Customer Retentions

Customer Service

Customer Support

Policies

Standards

Procedures

Education

High School Diploma or Equivalent

Job description

Location

Work from home (Pennsylvania)

Shift

Days (United States of America)

Scheduled Weekly Hours

40

Worker Type

Regular

Exemption Status

No

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.

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)

Skills

Communication, Customer Retentions, Customer Service, Customer Support Policies, Standards And Procedures

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, we encourage an atmosphere of collaboration, cooperation and collegiality.

Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.