Job Description
Title: Rx Customer Service Specialist (US)
Location: Remote
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
Providing high quality services to client and beneficiaries is at the core of what we do every day! The PBM Operations & Services team is the very heart of Abarca and meets that standard by running services from MTM, price eligibility, configurations, and beneficiary services to government services and beyond. Rx Customer Service leads the front lines in conducting satisfaction surveys, addressing complaints, managing manual reversal requests and other needs for our beneficiaries, pharmacies, and clients.
As the Rx Customer Service Specialist, you will serve at 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.
The fundamentals for the job
- Manage all incoming calls, emails, faxes and web-generated requests from pharmacies, beneficiaries, and prescribers.
- Provide 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.
- 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 and company policies and guidelines.
- Answer questions and recommend corrective services to address customer complaints, payment status, manual reversal requests, benefit and 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 required.
- 3+ years of experience working in a Pharmacy or Member Services Call Center, Retail or Hospital Pharmacy Setting.
- Excellent oral and written communication skills.
- Bilingual fluency in Spanish and English is required.
Nice to haves
- Current and Active Pharmacy Technician License.
- Experience in PBM, Medicare Part D, Commercial/Employer Plans, Insurance, Pharmacy, and / or healthcare.
That something extra we d love to see
- Analytical
- Problem Solver
- Detailed
Physical requirements
- Must be able to access and navigate each department at the organization’s facilities.
- Sedentary work that primarily involves sitting/standing.