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Customer Service Jobs in Philadelphia, PA

Pharmacy Call Center Tech

Integrated Resources, Inc

Philadelphia, Pennsylvania

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JOB DETAILS
JOB TYPE
Contractor
SKILLS
Biology, Call Centers, Call Monitoring, Claims Processing, Clinical Research, Contact Management, Contract Review, Corporate Policies, Desktop PC, Diversity, Healthcare, High School Diploma, Identify Issues, Information Technology & Information Systems, Long-Term Care, Medications, Performance Analysis, Performics, Pharmacy, Problem Solving Skills, Rehabilitation Nursing, Retail, Systems Maintenance, Team Player, The Joint Commission (TJC), Time Management
LOCATION
Philadelphia, Pennsylvania
POSTED
Today
Pharmacy Call Center TechIntegrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.Job DescriptionPosition Title: Pharmacy Call Center TechLocation: Philadelphia, PADuration: 3 Months Contract to PermJob Summary: Under the direct supervision of the Supervisor, Pharmacy Services Call Center, the Pharmacy Call Center Technician is responsible for providing knowledgeable and courteous customer assistance and response to members, providers and Pharmacy Call Center Technician inquiries.Principal Accountabilities:Handles calls and correspondence regarding pharmacy issues from providers/physicians and members.Identifies and/or responds to inquiries, benefit payments, complaints, dissatisfactions, grievances and claim issues.Documents calls in inquiry tracking system.Using established protocols ensures resolutions provided are presented in a clear and accurate manner.Facilitates problem resolution and acts as customers advocate.Reviews daily work activity report to self-monitor performance and productivity standards. Identifies deficiencies/problems and adjust behavior and work activities as appropriate.Follows internal process and procedures to ensure activities are handled in accordance with departmental and company policies/procedures.Performs initial research of pharmacy issues.Reconciles plan information utilizing department-generated procedures and reference materials.Appropriately escalates claims outside knowledge and/or clinical scope to higher-level call center staff or pharmacist for review.Utilizes internal Pharmacy systems to update, modify and extract member information.Assists network pharmacist in processing prescription claims.Reviews claims for accuracy and adherence to contract guidelines.Reviews and authorizes appropriate faxed medication requests from institutional/long term facilities and maintains consistent contact with all facilities to assure organization's protocols are maintained.Assists with entering prior authorizations when required; provides follow up assistance for prior authorization requests, follow up with request from physicians for denial letters, provides assistance in gathering historical claim information as required.Provides Level II Pharmacy Technician, Supervisor and/or Pharmacist with background data needed for claim review, appeals and grievances.Discriminates between routine and significant matters; apprises management of issues which can negatively affect service and business.Identifies provider/physician/member issues and refers to appropriate departments.Suspend inquiries forwarded to pharmacists or other departments and follows through to ensure timely resolution.Maintains a balance of productivity, quality and timeliness of job accountabilities.Participates in department self-audits procedures for on-going evaluation of services.Identifies and defines problems and opportunities within work area and attempts to resolve through appropriate channels.Demonstrates flexibility and cooperation when faced with changing priorities to meet shifting needs.Creates and supports an environment which fosters teamwork, cooperation, respect and diversity.Establishes and maintains positive communication and professional demeanor with employees and clients at all times.Adheres to company policies and procedures; supports and carries out the Mission and Values.Demonstrates and supports commitment to corporate goals and mission.Performs other related duties and projects as assigned.Assist with training of new hires.Attends required training as requested.Develop and maintain desktop procedures.QualificationsEducation and Training: High School diploma or the equivalentExperience: • 2 years Pharmacy Technician experience in a healthcare, long term care or retail environment.• Minimum 35 wpm typingAdditional InformationThanks & Regards,Seema ChawhanClinical RecruiterIntegrated Resources, Inc.IT Life Sciences Allied Healthcare CROCertified MBE |GSA - Schedule 66 I GSA - Schedule 621IDIRECT # - 732 – 318 -6506 | (W) # 732-549-2030 – Ext – 324 | (F) 732-549-5549Email id – seema @irionline.com| www.irionline.comGold Seal JCAHO Certified for Health Care Staffing"INC 5000's FASTEST GROWING, PRIVATELY HELD COMPANIES" (8th Year in a Row)

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