Specialty Operations Pharmacy Technician

About the role

The Specialty Operations Pharmacy Technician 2 supports Pharmacists in Specialty Rx medication preparation by dispensing Specialty Rx medications. The Pharmacy Claims Representative 2 analyzes and answers inquiries regarding pharmacy claims adjudication, including method of payment, co-pay or deductible amounts, and/or reason for denial. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

Responsibilities

• Adjudicate pharmacy claims and process pharmacy claims for payment
• Perform varied activities and moderately complex administrative/operational/customer support assignments
• Perform computations
• Work on semi-routine assignments

Required Qualifications

• Must have an active license with the Board of Pharmacy in the appropriate state
• Must be PTCB certified
• 1+ year of claims processing, insurance or pharmacy experience
• Must have strong MS Office skills as this role is report heavy

Preferred Qualifications

• Inbound/Outbound call experience
• Customer service experience
• Strong communication skills

Work at Home Requirements

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested
• In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Travel

While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Pay

$40,000 - $52,300 per year

Benefits

• Medical, dental and vision benefits
• 401(k) retirement savings plan
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• Short-term and long-term disability
• Life insurance