Pharmacy Benefits Specialist

Profile

Job ID 21000N9VAvailable Openings 1PURPOSE AND SCOPE: Reviews, verifies, and processes orders in the pharmacy management system’s work queue. Finds and acts upon trends in pharmacy data that will help the pharmacy improve customer retention and success. PRINCIPAL DUTIES AND RESPONSIBILITIES: Reviews, collects, executes tasks, and communicates information to management team related conversion efforts. Analyzes reports from pharmacy data system. and researches and corrects any discrepancies identified, which may include all functional departments Accurately and thoroughly document information into New Leaf and/or Salesforce about each contact handled (email, inbound and outbound calls), following defined parameters. Generate the appropriate task, assignment; follow up, note or resolution for each task Ensure timely resolution to consumer contact issue whether it is an e-mail, inbound or outbound call Update and complete tasks that have been assigned by the supervisor or manager. Prepare feedback and reports, as needed, that will provide actionable insights to pharmacy conversion rate optimization.. Helps define and maintain key performance indicators (KPIs) by assisting in building reports and tracking conversion data Works on assignments requiring judgment and takes action around conversion efforts. Verifies insurance coverage by phone, online or through E1 (electronic system) transactions for all new patients and/or changes in coverage. Makes contact (via telephone and/or email) with patients and Fresenius Medical Care clinics as needed to address a patient’s order Answers patients’ questions regarding insurance coverage and financial assistance options. Reviews all enrollment forms. Ensures insurance information and appropriate referrals have been completely and accurately obtained. May be required to follow up with social worker, insurance company, and/or patient to complete the application and verify insurance. Demonstrates knowledge and understanding of insurance billing requirements. Monitors all patients’ insurance information to ensure that it is updated and accurate. Addresses any identified anomalies or discrepancies, researches and answers questions as needed. Contacts patients and reports on retention of transferred out prescriptions. Calls prescriber and/or clinic for verbal scripts, or transfers scripts from other pharmacy if patient chooses to transfer Rx back to FMC. Enters prescriptions as needed for resolution and workload support. Speaks with physicians or nurses to verify correct information about a specific prescription. Possess comprehensive knowledge of company procedures and product information/materials. Review and comply with the Code of Business Conduct and all applicable company policies and procedures, local, state and federal laws and regulations. Assist with various projects as assigned by direct supervisor. Other duties as assigned. Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions. PHYSICAL DEMANDS AND WORKING CONDITIONS: The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. SUPERVISION: High performing role requiring limited supervision. Receives minimal instruction on work considered to be routine. General instructions on newly introduced assignments. EDUCATION: High School Diploma and a minimum of 2-4 years related experience required Pharmacy Technician Certification and Licensure preferred EXPERIENCE AND REQUIRED SKILLS: 2 - 4 years pharmacy and insurance experience preferred. Excellent customer service, communication, organizational and interpersonal skills required. Understands the importance of and demonstrates a customer service philosophy. Excellent written and verbal communication skills. Excellent organizational, analytical, and problem-solving skills. Detail oriented with the ability to enter information accurately on paper and into a database system. Proficient with PCs and Microsoft Office Suite applications including Microsoft Excel and PowerPoint Possess a working knowledge of pharmacy dispensing regulations, pharmacy data systems, and pharmacy billing practices and policies. Possess a working knowledge of standard medical abbreviations and medical terminology. EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.,identifier:21000N9V,qualifications:PHYSICAL DEMANDS AND WORKING CONDITIONS: The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. SUPERVISION: High performing role requiring limited supervision. Receives minimal instruction on work considered to be routine.  General instructions on newly introduced assignments. EDUCATION: High School Diploma and a minimum of 2-4 years related experience required Pharmacy Technician Certification and Licensure preferred EXPERIENCE AND REQUIRED SKILLS: 2 - 4 years pharmacy and insurance experience preferred. Excellent customer service, communication, organizational and interpersonal skills required. Understands the importance of and demonstrates a customer service philosophy. Excellent written and verbal communication skills. Excellent organizational, analytical, and problem-solving skills. Detail oriented with the ability to enter information accurately on paper and into a database system. Proficient with PCs and Microsoft Office Suite applications including Microsoft Excel and PowerPoint Possess a working knowledge of pharmacy dispensing regulations, pharmacy data systems, and pharmacy billing practices and policies. Possess a working knowledge of standard medical abbreviations and medical terminology. EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.,title:Pharmacy Benefits Specialist,url:****/ Clerical,hiringOrganization:{@type:Organization,name:Fresenius Medical Care},jobLocation:{@type:Place,address:{@type:PostalAddress,addressLocality:Franklin,addressRegion:TN,addressCountry:United States,streetAddress:,postalCode:37067}}}

Company info

Sign Up Now - HRCrossing.com