Pharmacy Technician Customer Service Representative

Job Title:

Pharmacy Technician-Customer Service Representative (Temporary one year or longer)

Industry: Healthcare

FSLA status:
Non-Exempt

Department:
Operations

Level: Entry to mid-level

Location:

Remote

Rate:

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our company’s growth, market presence and our ability to help our clients stay ahead of the competition. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.

NTT DATA Services currently seeks a Pharmacy Technician-Customer Service Representative to join our team for a one year or longer temporary assignment.

You’ll join and work with a team of talented people who enjoy solving tough problems and improving the healthcare industry. They believe in supporting both personal and professional growth. That means, they pay attention to goals, celebrate milestones and highly encourage learning opportunities.

This position takes in-coming calls from members, providers providing professional phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of all approvals and denials, and transfers all clinical questions and judgment calls to the pharmacist. Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.

Determines appropriateness for medications. Communicates decision to physicians, physician’s office staff, medical management staff, and/or pharmacists. Communicates selected prior authorization criteria, pharmacy benefit coverage, and formulary alternatives to physicians, physician’s office staff, medical management staff, and/or pharmacists. Research, resolve, and documents prior authorization outcomes in the pharmacy system. Escalates requests to Pharmacist when request requires extensive clinical review or denial.

Research, resolve, and documents physician or client inquiries and grievances. Provides verbal or written results to client, prescriber, provider, and/or management. Performs other duties as required.

• Answers questions and resolves issued from members, providers, medical professionals, and plan sponsors
• Triage to staff accordingly
• Document and track contacts with members, providers, and plan sponsors
• Provide notification to members on decisions, changes, or other relevant information
• Communicate coverage, authorization, and eligibility information to member or provider
• Prioritizing and organizing workload in adherence to deadlines
• Ability to multi-task to accomplish workload efficiently

• 1+ years of experience in Customer Service in a Call Center environment
• 1 + years of prior pharmacy background or healthcare
• 1+ years of experience in a position involving research, problem solving, and timeline responsiveness
• 1+ year of Microsoft Office to include Excel and Word
• Sate Registration Certification or National Certification Preferred not required
• High School Diploma or Equivalent

All duties and responsibilities are essential job functions and are subject to possible modification to reasonably accommodate individuals with disabilities. Other functions and accountabilities may be assigned from time to time. Regular attendance is an essential function of this position. To perform this job successfully, the employee will possess the skills, aptitudes, and abilities to perform each duty proficiently.

Requires sitting for long periods of time. Some…