Pharmacy Help Desk Representative

Location: Irving, TX
Description: Judge Group is currently seeking a Pharmacy Help Desk Representative to provide customer service to incoming and outbound calls to providers, beneficiaries and pharmacies.
This is a full time, permanent opportunity! Offering competitive salary, benefits, and PTO for the qualified candidate selected!
This job will have the following responsibilities:
  • Answer incoming pharmacy calls regarding issues related to a claim transaction, reimbursement, and payment
  • Answer incoming providers’ and beneficiaries’ calls 
  • Follow HIPAA and Pharmacy Laws Standards. 
  • Identify pharmacies, providers and beneficiaries needs, clarify information, research every issue and providing solutions. 
  • Document all inquiries in system
  • Route the case to the corresponding internal department or the appropriate Health Insurance Carrier. 
  • Guide pharmacies, providers and beneficiaries regarding the process of claim transmission, reimbursement and payment. 
  • Evaluate on an individual basis to determine if the patient meets the criteria for a coverage determination for alerts such as DURs (Drug Utilization Reviews), HMO (Health Maintenance Organization) among other rejections evaluations required by business. 
  • Identify system issues and route to the corresponding internal department. 
  • Make outbound calls to pharmacies, providers and beneficiaries if necessary. 
  • Support all Quality Management Program initiatives. 

Qualifications & Requirements:
  • Pharmacy Technician, Technical or Associate Degree
  • Bilingual (Spanish & English)
  • 1 - 2-year customer service or call center experience and healthcare environment
All interested candidates should email an up to date resume to Tim (Tarnold@judge.com) or apply directly to this post for immediate consideration!

Contact: tarnold@judge.com
This job and many more are available through The Judge Group. Find us on the web at www.judge.com
Company
The Judge Group
Posted
10/06/2021
Type
Full time
Salary Range
$36,000.00 - 49,000.00
per Year
Salary range estimated by
Location
Irving, TX 75084, US
Apply Now