Customer Care Pharmacy Technician (Full-Time)

Position Responsibilities

• Act as the primary point of contact for incoming member calls, prior authorization inquiries, and ensure appropriate escalation of cases and all intake notes to the Clinical Prior Authorization Team.
• Actively intake a thorough and complete prior authorization request from prescribers and members by asking applicable drug and client-specific clinical questions.
• Accurately advise callers on options for exception requests (formulary, copay, early refill, etc.) based on client benefit elections and provide additional information and status updates to prescribers, members, and pharmacies.
• Efficiently triage incoming calls with professional phone etiquette from members, prescribers, and pharmacies with minimal support. Ask probing questions to identify and resolve all issues and address concerns promptly.
• Act as a valuable resource for Customer Service Representatives supporting member and pharmacy inquiries, stepping in as needed based on demand.
• Proactively identify, document, and address member and pharmacy concerns to ensure everyone receives the care and attention they deserve.
• Effectively communicate issues and solutions to members, pharmacies, and relevant internal stakeholders to ensure customers receive quality care and that the resolution meets all health and safety standards.
• Ensure customer satisfaction, extraordinary customer care, and quality resolution with genuine compassion in a fast-paced environment.
• Follow all internal Standard Operating Procedures and adhere to HIPAA guidelines and Company policies.
• Assist with onboarding and training of new team members or temporary staff as needed.
• Support the Fraud, Waste, and Abuse program by reviewing pharmacy claims information and communicating findings to appropriate internal staff.
• Collaborate across different systems while utilizing up to two monitors, efficiently multitasking in a dynamic and fast-paced environment.
• Self-starter who displays a positive attitude, strong work ethic, and excellent attendance.
• Meet all departmental goals including schedule adherence, attendance, and quality monitoring.
• Standard hours for training: Monday thru Friday, 9:00 am – 5:30 pm, Eastern.

Required Qualifications

• A high school diploma or the equivalent; an associate or bachelor’s degree preferred.
• A current National Certification as a Pharmacy Technician (CPhT) and a valid license are required.
• 2+ years of pharmacy technician experience in a clinical pharmacy setting.
• PBM, Health Plan, or related Health Care experience required.
• 2+ years of customer service experience with a passion for building customer loyalty through exceptional listening, relationship building, and strong written and verbal communication.
• Experience handling prior authorization requests/understanding of prior authorization requirements preferred.
• Ability to work independently with minimal supervision, stay productive in a remote, high-volume, fast-paced, metric-driven call center environment.
• Tech-savvy with proficiency in CRM systems, call center platforms, and Microsoft Office Suite.
• Demonstrated ability to meet performance metrics including call quality, resolution time, and customer satisfaction.
• Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. 1 Gig plan required.

Preferred Attributes

• Bilingual Spanish highly preferred.
• Medicare experience preferred.
• Passion for healthcare and improving patient outcomes.
• Adaptability in a startup or high-growth environment.
• Experience supporting pharmacy operations or benefits administration.
• Commitment to diversity, equity, and inclusion.