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Part D Pharmacy Technician Posted Jun 04
BroadPath Healthcare Solutions , Tucson, AZ
The Medicare Part D Pharmacy Technician will make outbound calls to members and physicians to improve medication adherence and other pharmacy related quality metrics, for a health insurance plan. They will also receive inbound calls, and provide accurate information to members regarding their Part D prescription coverage. They are responsible for gathering prescription refill orders and providing excellent customer service as well as troubleshooting any pharmacy related issues.

Basic Qualifications:

Certified Pharmacy Technician (CPhT)

Minimum of 2 years of experience in pharmacy operations

Extensive knowledge of the Medicare Part D, particularly the pharmacy record review, claims, billing and reimbursement rules

Working knowledge of HIPAA Privacy and Security Rules and CMS security requirements

Familiarity with the adjudication process and third party insurance rejections

Working knowledge of Medicare Part D coverage guidelines and payment methodologies

General writing skills and ability to produce work free from typographical or spelling errors

Strong technical skills (Microsoft Windows, keyboarding skills, strong systems aptitude, etc.)

Strong computer and telephone multitasking skills including: the ability to effectively search for and type information on the computer, navigate through multiple windows and screens quickly, and inputting information accurately while keeping pace with the call

Excellent verbal and written communication skills

Ability to remain focused and productive each day though tasks may be repetitive 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

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

Exhibits excellent phone and communication skills while providing complete and accurate information to members

Adheres to assigned schedule and quality metrics

Closely follows all policy and procedures for Medication Adherence Initiatives Preferred Qualifications:

Previous successful work at home experience

About the Company

BroadPath provides specialized business, compliance, and technology services to healthcare payers and providers in commercial and government sectors.

We focus solely on healthcare, so our team understands our clients' issues in a way few others can. And since we work with the country's top healthcare organizations, we have unique insight into the industry's best practices and of the dynamics and regulations affecting operations and outcomes.

Employment Type: Permanent

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