ExactCare logo
ExactCare

A national medication management and long-term pharmacy provider for people with complex, chronic needs

Customer Support Specialist

Customer SupportCustomer SupportFull TimeRemoteSeniorTeam 501-1,000Since 2009H1B No SponsorCompany SiteLinkedIn

Location

Wisconsin

Posted

3 days ago

Salary

0

Seniority

Senior

Associate Degree3 yrs expExperience acceptedEnglish

Job Description

Customer Support Specialist

ExactCare

• Answer telephone inquiries in a pleasant, professional, and efficient manner assuring exceptional customer service. • Document all incoming calls and dialogue in the claims adjudication software. • Educate clients on plan policies, benefits, and procedures. • Resolve client drug benefit concerns of a medical, financial, or technological nature. • Initiate and facilitate prior authorization requests. • Make outbound calls to pharmacies and plans to facilitate completion of JIRA tickets. • Review after hours calls log-complete any follow up as needed. • Submit JIRA tickets for compound prescriptions. • Submit JIRA tickets to resolve NDC issues (pricing issues, missing NDCs). • Stay current on plan and benefit structures, pharmacological updates, and Medicare Part D guidelines. • Accept other duties as assigned; including but not limited to direct member reimbursement, processing, manual claims, reporting, and researching rejected claims. • Ensures that HIPAA guidelines are followed in every communication with clients.

Job Requirements

  • Associate’s degree or equivalent combination of education or work experience
  • CPhT (Certified Pharmacy Technician) Certification preferred
  • A minimum of 3 years of experience in customer service/member service in a call center or similar
  • A minimum of 2 years of experience in the healthcare industry
  • A minimum of 2 years of experience in a pharmacy support role
  • Knowledge of plan and benefit structures and Medicare guidelines.
  • Knowledge of pharmacology and pharmacological terms
  • Excellent communication skills and professionalism when working with clients
  • Ability to solve problems under pressure by making immediate decisions while on the phone
  • Detail oriented and able to prioritize workload
  • Strong computer skills including using word processors, spreadsheets, and database software.

Benefits

  • Medical, dental and vision coverage effective 1st of the month following date of hire
  • Flexible spending
  • Company-paid life insurance and short-term disability
  • Voluntary benefits
  • 401(k)
  • Paid Time Off
  • Paid holidays

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