Remote Pharmacy Member Care Specialist

Molina Healthcare; United States; Remote; USD 22,000 - 28,000; Full time

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare is seeking a Pharmacy Customer Service Representative to support inbound and outbound pharmacy calls. The role is remote but requires residency in New Mexico.

You will assist members, providers, and pharmacies with prior authorizations, coverage determinations, and plan benefits while maintaining high-quality service and accurate records. Strong communication, multitasking, and independent work abilities are essential, as well as proficiency with Microsoft Excel and the Office

Qualifications

• 1+ year of call center or customer service experience.
• Excellent verbal and written communication skills.
• Ability to multitask while speaking with members.
• Ability to work independently on special projects.

Responsibilities

• Handle inbound and outbound pharmacy calls from members, providers, and pharmacies.
• Coordinate and process pharmacy prior authorization requests and/or appeals.
• Explain coverage policies and formulary information to providers, members and pharmacies.
• Assist with day-to-day call center operations and clerical tasks as needed.
• Maintain accurate call records in the pharmacy call tracking system.
• Ensure adherence to call quality and quantity standards.
• Identify ways to improve member relations and call center processes.

Skills

Customer service

Verbal communication

Written communication

Multi-tasking

Time management

Independent work

Tools

Microsoft Excel

Office suite

Job description

Molina Healthcare is seeking a Pharmacy Customer Service Representative to support inbound and outbound pharmacy calls. The role is remote but requires residency in New Mexico.

You will assist members, providers, and pharmacies with prior authorizations, coverage determinations, and plan benefits while maintaining high-quality service and accurate records. Strong communication, multitasking, and independent work abilities are essential, as well as proficiency with Microsoft Excel and the Office