Pharmacy Technician Customer Service Representative

NTT DATA Group Corporation; New Shoreham (RI); Remote; USD 37,000 - 42,000; Full time

Job summary

NTT DATA, Inc. is seeking a Pharmacy Technician-Customer Service Representative for a remote, temporary one-year or longer assignment in Healthcare.

The role handles incoming calls from members, providers and uses prior authorization criteria, documents approvals/denials, and escalates to the pharmacist as needed.

Qualifications

• 1+ years of experience in Customer Service in a Call Center environment.
• 1+ years of prior pharmacy background or healthcare
• 1+ years of experience in a position involving research, problem solving, and timeline responsiveness
• 1+ year of Microsoft Office to include Excel and Word
• State Registration Certification or National Certification Preferred not required
• High School Diploma or Equivalent

Responsibilities

• Answers questions and resolves issued from members, providers, medical professionals, and plan sponsors
• Triage to staff accordingly
• Document and track contacts with members, providers, and plan sponsors
• Provide notification to members on decisions, changes, or other relevant information
• Communicate coverage, authorization, and eligibility information to member or provider
• Prioritizing and organizing workload in adherence to deadlines
• Ability to multi-task to accomplish workload efficiently

Skills

Customer service

Call center

Pharmacy background

Research skills

MS Office (Excel/Word)

Certification preferred

High school diploma

Education

High School Diploma or Equivalent

Job description

Job Title: Pharmacy Technician-Customer Service Representative (Temporary one year or longer)

Industry: Healthcare

FSLA status: Non-Exempt

Department: Operations

Level: Entry to mid-level

Location: Remote

Rate: 18.00-20.25

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our company's growth, market presence and our ability to help our clients stay ahead of the competition. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.

NTT DATA Services currently seeks a Pharmacy Technician-Customer Service Representative to join our team for a one year or longer temporary assignment.

You’ll join and work with a team of talented people who enjoy solving tough problems and improving the healthcare industry. They believe in supporting both personal and professional growth. That means, they pay attention to goals, celebrate milestones and highly encourage learning opportunities.

JOB SUMMARY

This position takes in-coming calls from members, providers providing professional phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of all approvals and denials, and transfers all clinical questions and judgment calls to the pharmacist. Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria. Determines appropriateness for medications. Communicates decision to physicians, physician's office staff, medical management staff, and/or pharmacists. Communicates selected prior authorization criteria, pharmacy benefit coverage, and formulary alternatives to physicians, physician's office staff, medical management staff, and/or pharmacists. Research, resolve, and documents prior authorization outcomes in the pharmacy system. Escalates requests to Pharmacist when request requires extensive clinical review or denial. Research, resolve, and documents physician or client inquiries and grievances. Provides verbal or written results to client, prescriber, provider, and/or management. Performs other duties as required

In this role you will be responsible for:

• Answers questions and resolves issued from members, providers, medical professionals, and plan sponsors
• Triage to staff accordingly
• Document and track contacts with members, providers, and plan sponsors
• Provide notification to members on decisions, changes, or other relevant information
• Communicate coverage, authorization, and eligibility information to member or provider
• Prioritizing and organizing workload in adherence to deadlines
• Ability to multi-task to accomplish workload efficiently

JOB QUALIFICATIONS

• 1+ years of experience in Customer Service in a Call Center environment
• 1 + years of prior pharmacy background or healthcare
• 1+ years of experience in a position involving research, problem solving, and timeline responsiveness
• 1+ year of Microsoft Office to include Excel and Word
• Sate Registration Certification or National Certification Preferred not required
• High School Diploma or Equivalent

ESSENTIAL FUNCTIONS

All duties and responsibilities are essential job functions and are subject to possible modification to reasonably accommodate individuals with disabilities. Other functions and accountabilities may be assigned from time to time. Regular attendance is an essential function of this position. To perform this job successfully, the employee will possess the skills, aptitudes, and abilities to perform each duty proficiently.

TYPICAL PHYSICAL DEMANDS

Requires sitting for long periods of time. Some bending, stretching or reaching required. Requires the physical dexterity to operate a keyboard, calculator, telephone, copier and other office equipment as necessary. Requires ability to perform data entry functions for 95% of the scheduled work shift and perform duties in a fast-paced environment with high demands and tight deadlines. Requires ability to view computer monitor for long periods of time without eyestrain.

About NTT Data, Inc

NTT DATA, Inc. partners with clients to navigate and simplify the modern complexities of business and technology, delivering the insights, solutions and outcomes that matter most. We deliver tangible business results by combining deep industry expertise with applied innovations in digital, cloud and automation across a comprehensive portfolio of consulting, applications, infrastructure and business process services. NTT DATA, Inc. is part of the NTT DATA family of companies, together comprising a top 10 global business and IT services provider with 100,000+ professionals in more than 50 countries, and is part of NTT Group, a partner to 85 percent of the Fortune 100. Learn more at https://us.nttdata.com/en/.

EEO Statement

NTT DATA, Inc. (the "Company") is an equal opportunity employer and makes employment decisions on the basis of merit and business needs. The Company will consider all qualified applicants for employment without regard to race, color, religious creed, citizenship, national origin, ancestry, age, sex sexual orientation genetic information, physical or mental disability, veteran or marital status, or any other class protested by law. To comply with applicable laws ensuring equal employment opportunities to qualified individuals with a disability, the Company will make reasonable accommodations for the known physical or mental limitations of an otherwise qualified individual with a disability who is an applicant or an employee unless undue hardship to the Company would result.