Job Description
Essential Duties/Responsibilities:
•Interpret prescription orders and enter data accurately and timely.
•Place outgoing phone calls to patients, doctors and insurance companies to obtain clarification on prescription orders (if applicable).
•Utilizes reasoning skills to identify missing information and make processing determinations based upon policy and client guidelines.
•Works under general supervision relying on instructions, work process guidelines, policy and procedures, and company knowledge/experience to perform the function(s) of the job.
•Contact patients to follow up on an incident or provide a resolution (if applicable).
•Research claims that have been rejected by the insurance and resolve the specified rejection.
•Perform other duties as assigned.
Required Skills/Abilities
•Strong interpersonal and customer service skills.
•Ability to maintain confidentiality of information and data in accordance with policies.
•Ability to exercise considerable judgment, maintain confidentiality, and act in a diplomatic manner.
•Ability to independently identify, research and resolve issues.
•A decisive individual who possesses a detail-oriented perspective.
•Sound technical skills, analytical ability, good judgment, and strong operational focus.
•Ability to work with peers in a team effort.
•Demonstrated ability to manage multiple priorities and deadlines.
•A well-organized and self-directed individual who is able to work with minimal amount of supervision.
•Capability to efficiently complete tasks in a fast-paced environment.
•Ability to lift heavy objects up to 15 pounds.
•Ability to work extended hours, weekends, and holidays in alignment with departmental and industry demands.
Education/Experience
•High School Diploma or GED.
•Registered Pharmacy Technician licensed and in good standing with applicable home State Board of Pharmacy and Michigan Board of Pharmacy.
•Certified Pharmacy Technician (CPhT), licensed through the Pharmacy Technician Certification Board (PTCB).
•Experience or knowledge of claims adjudication preferred.
•Experience or knowledge of secondary billing practices including prescription discount cards and Medicaid.
•Proficient in Microsoft Office and industry related software programs
Preferred Skill/Abilities:
•Prior experience in Retail, Mail Order of Specialty Pharmacy, PBM, pharmaceutical or managed health care industry preferred.
Work Environment/Physical Requirements:
•Hybrid home/office environment, with minimal exposure to excessive noise or adverse environmental issues, and occasional local and/or overnight travel, including exposure to heat, cold, and inclement weather conditions. Transportation for travel typically will include automobile and plane.
•Ability to sit and stand for prolonged periods of time.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor. Birdi
Job Tags
Holiday work, Local area, Home office, Night shift, Weekend work,