Remote Pharmacy Call Center Specialist

Summary

Join Abarca as Associate Rx Customer Service Specialist and serve at the front line of all incoming and outgoing communication with pharmacies, beneficiaries, and prescribers. Manage calls, emails, faxes, and web-generated requests, provide service-level standards, and report identified issues to the appropriate department.

Requirements

• Pharmacy Technician Associate Degree preferred (In lieu of a degree, equivalent relevant work experience may be considered.)
• 1 + year s of experience working in a Pharmacy or Member Services Call Center, Retail or Hospital Pharmacy Setting
• Excellent oral and written communication skills , b ilingual fluency in Spanish and English is required

Responsibilities

• 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

Benefits

Flexible hybrid work model which will require certain on-site work days (Puerto Rico Location Only)