Verify member information and input data for pharmacists
Process prior auth requests from physicians and ensure regulator compliance with Medicare requirements
Provide resolution to grievances and appeals issues
Respond to inquiries
Enter and maintain accurate records
Document outreach to members
Manage incoming calls, faxes and ePAs
Refer cases requiring clinical review
Develop and maintain positive customer relations
This position requires that you be available to work 40 hours a week with up to a 10 hour shift between 8am-11pm Eastern. This is a Monday - Friday position or up to an 8 hour shift between 10am - 6pm on weekends
Requires a high school diploma; up to 1 year of previous experience in an automated customer service environment; or any combination of education and experience, which would provide an equivalent background. Basic computer and written, oral and interpersonal communications skills required.
Strong computer skills strongly preferred
Prior call center experience strongly preferred
• Medical terminology training, pharmaceutical terminology experience and/or experience in medical, insurance or pharmaceutical field are preferred
Requires National Pharmacy Tech Certification
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At TotalMed, partnering with Pharmacy Companies runs deeper than just staffing. Knowing that quality, accessibility, and affordability of care are the top priorities, you shouldn’t have to add another focus: hiring the right personnel.
Our Pharmacy division focuses solely on the hiring needs of Pharmaceutical Organizations across the country. By combining technology and recruitment functions, we’re committed to making it easier for you to keep communities healthy through quality, individualized care.