Pharmacy Customer Service Representative

Improve the lives of others while Caring. Connecting. Growing together.

Job Description - Pharmacy Customer Service Representative (2397998)

Pharmacy Customer Service Representative (Job Number: 2397998)

This position is National Remote. You’ll enjoy the flexibility to telecommute
* from anywhere within the U.S. as you take on some tough challenges.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities.

Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.

As a Pharmacy Customer Service Representative or As a Specialty Prior Authorization coordinator, your role will focus on notifying a provider when a prior authorization is required for specialty patients with acute and chronic disease states. In this role you will be preparing prior authorizations for submission, follow up on prior authorization outcome, addressing issues and handling concerns from other corresponding departments.

You’ve heard this all your life. Trust matters. Being trusted matters a lot. Here at Optum Rx we’ve earned the trust of more than 65 million people who rely on us for the prescription drugs that improve their health and lifestyle. Now, we trust that you can take advantage of some of the best training and tools in the world to help serve our customers and their care providers.

This is no small opportunity. This is where you can bring your compassion for others while building your career.

This position is full-time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00 am - 7:00 pm CST. It may be necessary, given the business need, to work occasional overtime.

We offer 3 weeks of paid training. The hours during training will be 9:00 am - 5:30 pm EST, Monday
- Friday.
Training will be conducted virtually from your home.

• Handle Initiating PA requests
• Accessing multiple Optum resources to check PA status and benefits
• Problem-solve with decisiveness and urgency and escalate to operations partners, team leads, management and other stakeholders
• Ensure patients and providers are supported by following escalation through to finish
• Focus on patient care and quality assurance

This role is equally challenging and rewarding. You’ll be called on to research complex issues pertaining to member prescription and/or pharmacy benefits across multiple databases which requires fluency in computer navigation and toggling while confidently and compassionately engaging with the caller.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

• High School Diploma / GED OR equivalent work experience
• Must be 18 years of age OR older
• 1+ years of customer service or healthcare industry experience
• Familiarity with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
• Ability to attend training from 9:00 am - 5:30 pm EST, Monday
  - Friday for 3 weeks
• Ability to work full-time. Employees are required to have flexibility to work any of our…