Pharmacy Call Center Representative

hace 4 semanas


San Juan, San Juan, Puerto Rico Aps Health Care Pr A tiempo completo

**Job Summary:**
Aps Health Care Pr is seeking a skilled Pharmacy Call Center Representative to manage telephone calls from pharmacies and providers related to pharmacy benefits, authorization requests, and drug use review. The ideal candidate will possess excellent communication skills and the ability to work in a fast-paced environment.

**Key Responsibilities:**
1. Manage telephone calls from pharmacies and providers in a timely, confidential, and courteous manner.
2. Document calls and/or drug requests with complete follow-up history of the patient through electronic records.
3. Provide orientation to pharmacies regarding pharmacy benefits.
4. Perform system overrides (e.g., prior authorization) on the PBM claims processing system to ensure that claims are correctly adjudicated.
5. Assist pharmacies with claim processing.
6. Assist in the training of pharmacy representatives.
7. Comply with all guidelines established by the Centers for Medicare and Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable.

**Requirements:**
Pharmacy Technician Course of an accredited school.
Possess an active professional unrestricted Pharmacy Technician License in good standing to practice in Puerto Rico territory.
Minimum 2 years' experience in retail pharmacy preferred.
Basic knowledge of physical and mental pharmacotherapies, in order to make accurate assessments of clinical cases.
Personal computer experience should include working with Microsoft Word, Excel, Power Point, and Outlook at the intermediate level at a minimum.



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