Remote Pharmacy Customer Service & Prior Auth Specialist

Geisinger; United States; À distance; USD 21 000 - 30 000; Plein temps

Résumé du poste

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.

Qualifications

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

Responsabilités

• 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.

Connaissances

Customer Service

Customer Retentions

Communication

Customer Support Policies

Formation

High School Diploma or GED

Description du poste

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.