What you’ll do
In a few words…
Abarca is igniting a revolution in healthcare. We built our company on the belief that with smarter technology we are redefining pharmacy benefits, but this is just the beginning.
As the Rx Customer Service Specialist, you will serve as the front line of all incoming and outgoing communication (calls, emails and faxes) with pharmacies, beneficiaries and prescribers. You will use Rx Platform and other resources as necessary to resolve caller’s needs. Furthermore, you’re the best at it because of your great customer service!!
The fundamentals for the job…
- You will manage all incoming calls, emails, faxes and web-generated requests from pharmacies, beneficiaries and prescribers.
- All calls must be managed within the service-level standards set by CMS or by client; 80% of calls should fall within service level, less than 5% abandon rate and speed to answer should be less than 30 seconds. You got this from the get go.
- Rejection support, including overrides.
- Provide Coverage Determination status to clients including exceptions and appeals.
- Administrative PAs- Document PA request inquiries, issues, status and resolution in accordance with federal and department / company policies and guidelines.
- Answer questions and recommend corrective services to address customer complaints, payment status, manual reversal requests, benefit/eligibility support, provider portal support and response to price appeals.
- Report identified issues to the appropriate department, for investigation and correction, following the established procedure.
What you’re made of
The bold requirements…
- Pharmacy Technician associate degree & current/active Certified Pharmacy Technician License (Required).
- 1-2 years of experience in Pharmacy Call Center, Retail or Hospital Pharmacy Setting retail.
- Knowledge of PBM clinical operations and Medicare Part D is a plus, big-time.
- Computer proficiency, knowledge of Microsoft Office products, and Internet experience is a must, of course.
- Customer Service Experience.
- Previous experience in insurance, pharmacy and / or healthcare is a plus.
- Excellent communication skills both oral and written. Bilingual fluency English & Spanish is required.
That something extra we´d love to see…
- Organized and attention to detail is key
- People Person with excellent interpersonal skills
- Action for Bias
- Must be able to access and navigate each department at the organization’s facilities.
- Sedentary work that primarily involves sitting/standing.
The above description is not intended to limit the scope of the job or to exclude other duties not mentioned. It is absolutely not a final set of specifications for the position. It’s simply meant to give readers an idea of what the role entails.
Abarca Health LLC is an equal employment opportunity employer and participates in E-Verify. “Applicant must be a United States’ citizen. Abarca Health LLC does not this time currently sponsor employment visas”
Abarca Health LLC is an equal employment opportunity employer and participates in E-Verify. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of gender, race/ethnicity, gender identity, sexual orientation, protected veteran status, disability, or other protected group status.