Pharmacy Call Center Representative

ESSENTIAL ROLES AND RESPONSIBILITIES Answer incoming pharmacy calls regarding claim transaction issues, reimbursement issues, payment issues, and others in accordance with PharmPiX call center performance metrics. Answer incoming providers’ and beneficiaries' calls in accordance with PharmPiX call center performance metrics. Answer incoming calls and perform outbound calls according to HIPAA Law standards. Verify the accuracy of the information with the pharmacy, provider and or beneficiary. Document all inquiries in the Customer Service Management Application. Route the case to the corresponding internal department or the appropriate Health Insurance Carrier. Send an e-mail to the appropriate person in the appropriate department. Talk with pharmacies, providers and beneficiaries while typing comments in the system for each call. Educate pharmacies, providers and beneficiaries regarding the process of claim transmission, reimbursement and payment. Make outbound calls to pharmacies, providers and beneficiaries if necessary. Support all Quality Management Program initiatives. Perform Special projects and/or other duties assigned by the Operation Manager / Call Center Supervisor. TRAINING & EDUCATION Technical or Associate Degree in Pharmacy Technician LICENSURE / CERTIFICATION Puerto Rico Board of Pharmacy Technician Registry Certificate (Preferred) PROFESSIONAL EXPERIENCE 1 – 2 year customer service or call center experience (Preferred). 1 year experience as a Pharmacy Technician. PROFESSIONAL COMPETENCIES Strong customer service skills Excellent phone, written, listening and follow-through skills. Skill in analyzing situations accurately and taking effective action. Attention to details. Ability to work with others to reach a solution. Be able to toggle between several software programs. Demonstrated effective organizational and communications skills. Strong verbal and written communications skills Fully Bilingual (Spanish / English written and verbal). Able to effectively interact with internal departments, PharmPiX clients, members and other healthcare professionals. Time Management Skills: Establishing priorities and accomplishing tasks in a timely manner. PC skills (Microsoft System)/System oriented. Ability to work in a fast-paced environment and multitask.