Associate Rx Customer Service Specialist (Temporary)

• 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.

• Associate's Degree in Pharmacy Technician (in lieu of a degree, equivalent, relevant work experience may be considered).
• 1+ years of experience working in a Pharmacy or Member Services Call Center, Retail or Hospital Pharmacy Setting.
• Excellent oral and written communication skills, bilingual fluency in Spanish and English is required.
• We are proud to offer a flexible hybrid work model which will require certain on-site workdays (Puerto Rico Location Only).
• To work remotely, must have a stable, secure, and efficient internet connection. Dedicated workspace observing HIPAA and PHI protocols.
• Must be available during the hours of operation of the call center including weekends and holidays.
• Excellent oral and written communication skills. Bilingual fluency in Spanish and English is required.
• We are proud to offer a flexible hybrid work model which will require certain on-site workdays (Puerto Rico Location Only).

• Active Pharmacy Technician License is preferred.
• Experience in PBM, Medicare Part D, Commercial/Employer Plans, Insurance, Pharmacy, and / or healthcare.

• Must be able to access and navigate each department at the organization's facilities.
• Sedentary work that primarily involves sitting/standing.

Abarca Health