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SalaryOverview:
A Pharmacy Call Center Specialist preforms as Pharmacy Help desk agent and is responsible for providing customer service for members and providers in all PHP benefit plans. Technicians will ensure callers receive service excellence utilizing scripting, and critical thinking skills to assist with pharmacy questions or claims processing issues with regards to drugs and pharmaceuticals.
How you belong matters here.
Why Join Us
Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
Inclusion and Diversity
Our culture is one of knowing and respecting our patients, members, and each other. We capture this in our Promise and CARES commitments.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses. Maximum Offer for this position is up to: USD $22.37/Hr. Compensation Disclaimer: The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.
Now hiring a Remote Certified Pharmacy Call Center Specialist
A Pharmacy Call Center Specialist preforms as Pharmacy Help desk agent and is responsible for providing customer service for members and providers in all PHP benefit plans. Technicians will ensure callers receive service excellence utilizing scripting, and critical thinking skills to assist with pharmacy questions or claims processing issues with regards to drugs and pharmaceuticals.
How you belong matters here.
We value our employees' differences and find strength in the diversity of our team and community.
At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.
Why Join Us
- Full Time - Exempt: No
- Job is based Rev Hugh Cooper Admin Center (NM Residents Only)
- Work hours: Days
- Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.
- Certified Pharmacy Technician-PTCB
- GED or High School diploma is required.
- Retail Pharmacy experience preferred
- Managed care customer service experience preferred
- Drug Information skills
- Develop and maintain positive customer or partner relationships and acts as a member/patient advocate.
- Respond to incoming calls routed through skill-based technology to meet quality standards and performance measurements. Is ready to take calls at the schedule time and spends the appropriate amount of time taking calls throughout their shift to resolve pharmacy related issues.
- Responds to questions or issues from PHP members and providers about pharmacy benefits, eligibility, coverage, terms and conditions, with respective benefit plans.
- Ability to analyze rejected pharmacy claims and identify resolution for successful claims submission and processing and respond to customer, partner or other PHS/PHP/Fluent business units to ensure accuracy of benefit interpretation with results within required time lines.
- Ability to use reference documents, such as D.A.R.T, Policies and Procedures and desktop procedures to complete tasks
- Ability to provide information to members and providers on issues related to benefit coverage, formulary, non-formulary criteria, or respective formulary coverage guidelines.
- Knowledge of drug nomenclature, basic pharmacology, dosage calculations, units of measure, prescription filling techniques, prescription documentation requirements, pharmacy laws and regulations, basic managed care pharmacy principles and insurance coverage issues.
- Knowledge of Pharmaceutical products, including oral, injectable, infusion products and chemotherapy drugs.
All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
Inclusion and Diversity
Our culture is one of knowing and respecting our patients, members, and each other. We capture this in our Promise and CARES commitments.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
