Pharmacy Care Technician

UnitedHealth Group•San Antonio, TX

1d•$18 - $32

About The Position

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Pharmacy Care Technician will make outbound calls to members and physicians to improve medication adherence and other pharmacy related quality metrics. Responsible for gathering prescription refill orders and providing excellent customer service as well as determining the eligibility of members applying for the Medical Assistance Program. May serve as a subject matter expert for the Pharmacy team. Location: 19500 International Highway 10 West, Building 1, San Antonio, TX Schedule: Monday to Friday 9:00am to 6:00pm CST with rotating Saturdays from 8:00am to 5:00pm CST

Requirements

High School Diploma/GED (or higher)
Active and unrestricted Pharmacy Technician license in the state of Texas
National Pharmacy Technician Certification (Certified Pharmacy Technician)
2+ years of experience in a pharmacy setting
1+ years of experience in a customer service setting
1+ years of experience with Medicare Part D, particularly the pharmacy record review, claims, billing, and reimbursement rules
1+ years of experience with HIPAA Privacy and Security Rules and CMS security requirements
1+ years of experience with Microsoft Office, internet, and e-mail
6+ months of previous Call Center experience
Intermediate level of writing skills and ability to produce work free from typographical or spelling errors

Nice To Haves

PBM experience
Advanced knowledge of NCPDP and other types of prescription drug claims
Working knowledge of Medicare Part B and Part D coverage guidelines and payment methodologies. Retail pharmacy experience
Bilingual (English/Spanish)

Responsibilities

Conduct a high volume of outbound calls to members to discuss reasons for non-compliant to medication(s), schedule pharmacy telephonic appointments, and/or obtain important follow up information from providers. Outbound calls are made primarily using an auto dialer requiring precision to detail and adaptability to type of response needed
May answer inbound calls from members and assists them with their inquiries. Routes calls to appropriate department if necessary
Follows system scripting and validates member demographic information
Documents the provider or member's record with accurate information obtained on the call
Performs desk and on-site review of all claims documentation to validate correct billing and that payment made to contracted pharmacies is supported and appropriate
Provides support to internal staff, subcontractors and providers with respect to Medicare drug related issues
May serve as a subject matter expert for the Pharmacy team and mentor new employees to the team as necessary
Participates in and contributes to the overall pharmacy quality improvement initiatives
Collects and maintains eligibility information in an appropriate and confidential manner
Enters all assigned applications within a specified time frame in order to ensure eligibility deadlines are met accordingly
Exhibits excellent phone and communication skills while providing complete and accurate information to members
Requests additional or supplemental information via correspondence in order to complete applications
Adheres to assigned schedule and quality metrics
Uses a multi-lined telephonic system to answer calls regarding eligibility requirements and medication refill orders
Follows all policy and procedures for the Medical Assistance Program
Performs all other related duties as assigned