- Answers and manages telephone calls from pharmacies and providers in a timely, confidential, and courteous manner.
- Documents calls and/or drug requests with complete follow-up history of the patient through electronic records.
- Provides orientation to pharmacies regarding pharmacy benefits.
- Performs system overrides (e.g., prior authorization) on the PBM claims processing system to ensure that claims are correctly adjudicated.
- Assists pharmacy's claim processing.
- Assists in the training of pharmacy representatives.
- Complies with all guidelines established by the Centers for Medicare and Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable.
- In addition, all other duties are assigned by the manager and/or supervisor.
- Pharmacy Technician Course at an accredited school.
- Possess an active professional unrestricted Pharmacy Technician License in good standing to practice in Puerto Rico territory.
Pharmacy Technician - San Juan - Target Human Resources Solutions
Description
Company Overview
Our client is a leading group in the provision of mental health services in Puerto Rico, providing services in practices in the health industry, such as telemedicine and home services.
Job Summary
The Pharmacy Call Center Representative manages telephone calls and Prior Authorizations from pharmacies and providers related to pharmacy benefits, authorization requests, and drug use reviews, among others, to ensure that claims are correctly and timely adjudicated.
Responsibilities
Requirements
EEO
"Somos un patrono con Igualdad de Oportunidades en el Empleo y tomamos acción afirmativa para reclutar a Mujeres, Minorías, Veteranos Protegidos y Personas con Impedimentos."