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

Geisinger; United States; Remote; USD 21.000 - 30.000; Vollzeit

Zusammenfassung

Geisinger Health Plan is seeking a Pharmacy Customer Service professional to support processing of prior authorization requests and to help implement pharmacy benefit policies. The role requires coordinating with providers and members to ensure accurate information and timely resolution of inquiries.

Responsibilities include weekend/holiday coverage, adherence to regulatory standards, and collaboration with pharmacists to resolve clinical issues.

Qualifikationen

• High School Diploma or GED required.
• Minimum of 2 years customer service experience.
• Strong communication and customer service skills.

Aufgaben

• 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.

Kenntnisse

Customer Service

Customer Retentions

Communication

Customer Support Policies

Ausbildung

High School Diploma or GED

Jobbeschreibung

Location Work from Home

Job Category Member Services, Geisinger Health Plan

Schedule Days

Work Type Full time

Department GHP Pharmacy Customer Service Team

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.

Education

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

Experience

Minimum of 2 years-Customer Service (Required)

Skills

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

About Geisinger

Founded more than 100 years ago by Abigail Geisinger, the system now includes ten hospital campuses, a 550,000-member health plan, two research centers and the Geisinger Commonwealth School of Medicine. With nearly 24,000 employees and more than 1,700 employed physicians, Geisinger boosts its hometown economies in Pennsylvania by billions of dollars annually. Learn more at geisinger.org(opens in new window) or connect with us on Facebook(opens in new window), Instagram(opens in new window), LinkedIn(opens in new window) and Twitter(opens in new window).