What are the responsibilities and job description for the Pharmacy Coordinator-CW position at TALENT Software Services?
Description:
Required :
High School Diploma/GED Required
Must be able to read and speak Spanish
Pharmacy Experience Required
Pharmaceutical Knowledge
3-5 yrs of Customer Service Required
Proficient in Microsoft Suite
Barrier Identification & Problem Solving
Preferred:
1-3 Healthcare Insurance Experience Strongly Preferred
Pharmacy Benefits Management Understanding
Please have candidate take "Pharmacy Coordinator" Glider assessment in Glider and provide link of their assessment on resume.
The Pharmacy Coordinator provides front line staff guidance, ensures effective and efficient delivery of Pharmacy call center services. Serves as first line reviewer in monitoring and ensuring adherence to the health plan's state and federal multiple drug benefit design offerings. This position responds to physician and pharmacy network provider inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior authorization medication exception requests. Will interact with pharmacy network providers to evaluate, educate and/or assist in addressing denied point of sale prescription claim transitions and coordination of benefits practices/procedures.
Required :
High School Diploma/GED Required
Must be able to read and speak Spanish
Pharmacy Experience Required
Pharmaceutical Knowledge
3-5 yrs of Customer Service Required
Proficient in Microsoft Suite
Barrier Identification & Problem Solving
Preferred:
1-3 Healthcare Insurance Experience Strongly Preferred
Pharmacy Benefits Management Understanding
Please have candidate take "Pharmacy Coordinator" Glider assessment in Glider and provide link of their assessment on resume.
The Pharmacy Coordinator provides front line staff guidance, ensures effective and efficient delivery of Pharmacy call center services. Serves as first line reviewer in monitoring and ensuring adherence to the health plan's state and federal multiple drug benefit design offerings. This position responds to physician and pharmacy network provider inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior authorization medication exception requests. Will interact with pharmacy network providers to evaluate, educate and/or assist in addressing denied point of sale prescription claim transitions and coordination of benefits practices/procedures.
Salary : $15 - $18