PHARMACY TECHNICIAN

Temporary Professional Integrated Services; Guaynabo (PR); On-site; USD 32,000 - 46,000; Full time

Job summary

JobRx, Inc. is seeking a Pharmacy Help Desk Call Center Representative to provide telephone-based customer service for providers, beneficiaries, and pharmacies.

The role reports to the Pharmacy Help Desk Supervisor and emphasizes adherence to HIPAA and pharmacy-related regulations, with responsibilities including documentation and case routing. The ideal candidate has 1–2 years in customer service or call centers in a healthcare setting and is fully bilingual.

Qualifications

• Pharmacy Technician certification or related education is required/preferred.
• Bilingual in Spanish and English is essential for calls and documentation.
• Experience in a healthcare call-center environment preferred.

Responsibilities

• Handle incoming pharmacy calls regarding claims, reimbursements, payments, and related information per performance metrics.
• Answer calls from providers and beneficiaries following scripts in a timely manner.
• Document inquiries in the customer service system and route to the appropriate departments.

Skills

Bilingual (Spanish/English)

Customer service

Phone etiquette

Active listening

Time management

Education

Pharmacy Technician education or associate degree

Tools

Microsoft Office

CRM software

Job description

POSITION SUMMARY

The Pharmacy Help Desk Call Center Representative reports to the Pharmacy Help Desk Call Center Supervisor and is responsible to provide a customer service by telephone of incoming and outbound calls to providers, beneficiaries and pharmacies.

ESSENTIALS ROLES AND RESPONSIBILITIES

1. Answer incoming pharmacy calls regarding issues related to a claim transaction, reimbursement, payment, and other required information in accordance with the Pharmacy Help Desk Call Center performance metrics.
2. Answer incoming providers' and beneficiaries' calls following Call Center scripts, in a timely matter and in accordance with the PBM call center performance metrics.
3. Answer incoming calls and perform outbound calls according to HIPAA and Pharmacy Laws Standards.
4. Identify pharmacies, providers and beneficiaries needs, clarify information, research every issue and providing solutions.
5. Document all inquiries in the Customer Service Management Applications such as, Service Desk, OneArk and email.
6. Route the case to the corresponding internal department or the appropriate Health Insurance Carrier.
7. Guide pharmacies, providers and beneficiaries regarding the process of claim transmission, reimbursement and payment.
8. Constantly monitors the BACMAN Alert Application to ensure proper management of rejections at point of sale.
9. Evaluate on an individual basis to determine if the patient meets the criteria for a coverage determination for alerts such as DURs (Drug Utilization Reviews), HMO (Health Maintenance Organization) among other rejections evaluations required by business.
10. Identify system issues and route to the corresponding internal department.
11. Make outbound calls to pharmacies, providers and beneficiaries if necessary.
12. Support all Quality Management Program initiatives.
13. Perform Special projects and/or other duties assigned by the Operations Manager and or Pharmacy Help Desk Call Center Supervisor.

TRAINING & EDUCATION

• Pharmacy Technician, Technical or Associate Degree

LICENSURE / CERTIFICATION

• Puerto Rico Board of Pharmacy Technician Registry Certificate (CPhT), or prospect.

PROFESSIONAL EXPERIENCE

• 1 - 2-year customer service or call center experience and healthcare environment (Preferable).

PROFESSIONAL COMPETENCIES

Knowledge:

• Fully Bilingual (Spanish / English written and verbal).
• PC skills (Microsoft System)/System oriented.

Skills:

• Strong customer service skills.
• Excellent phone, written, active listening and follow-through skills.
• Skill in analyzing situations accurately and taking effective action.
• Attention to details.
• Time Management Skills: Establishing priorities and accomplishing tasks in a timely manner.
• Ability to work with others to reach a solution.
• Be able to toggle between several software programs.
• Demonstrated effective organizational skills.

TPIS is an Equal Opportunity Employer (EEO Employer / Affirnti / Disabled / Veterans). We comply with all Federal, State and Local laws regarding nondiscrimination.