Member Document Specialist

Job Description

Job Description

Who We Are :

SmithRx is a rapidly growing, venture-backed Health-Tech company. Our mission is to disrupt the expensive and inefficient Pharmacy Benefit Management (PBM) sector by building a next-generation drug acquisition platform driven by cutting edge technology, innovative cost saving tools, and best-in-class customer service.

With hundreds of thousands of members onboarded since 2016, SmithRx has a solution that is resonating with clients all across the country.

We pride ourselves for our mission-driven and collaborative culture that inspires our employees to do their best work. We believe that the U.

S healthcare system is in need of transformation, and we come to work each day dedicated to making that change a reality.

At our core, we are guided by our company values :

• Integrity : Always operate with honesty and transparency so we earn the trust of our clients.
• Courage : Demonstrate the courage needed to take on a broken industry and continuously improve what we offer to optimize health outcomes.
• Together : Foster a collaborative and inclusive environment that values teamwork, respect, and open communication, and encourages creativity and diversity of thought.

Job Summary :

We believe that an excellent customer support team is the lynchpin between happy customers and a best-in-class product. In healthcare specifically, exceptional service is of the utmost importance, as it enables our members (patients) to access appropriate care.

Successful candidates will have excellent attention to detail, accuracy, the ability to adapt to changes, and data entry skills.

If you like working in a fast-paced environment and demonstrating compassionate, genuine care for members and customers, this job is for you!

What you will do :

• Review and process inbound documents regarding member cases (medication prior authorizations, access and payment inquiries) and initiate workflows for downstream teams to support members, physicians, and pharmacies supporting a world-class member experience.
• Look up pharmacy benefit information across our platforms to identify appropriate next steps within workflow.
• Route inquiries needing further investigation to the appropriate department and conduct routine research as needed.
• Demonstrate a patient-centric mindset and a high sense of urgency.
• Work with highly sensitive information while maintaining Personal Protected Information (PPI) and the Health Insurance Portability & Accountability Act (HIPAA).
• Work inbound email queues to resolve member, provider, and pharmacy inquiries while providing exceptional customer service

What you will bring to SmithRx :

• Must be locally based as the role requires working onsite at our Lehi office. Potential to work fully remote based on performance, after 6 weeks
• HS Diploma, GED or equivalent
• 1+ years experience working in an administrative role
• Excellent attention to detail
• Ability to produce high quality and accuracy through efficient processes
• Ability to multitask
• Excellent verbal and written communication skills
• Passion for helping people
• Proficiency in Windows, and Google Suite
• Monday through Friday work schedule, with rotating holiday shifts
• Prior experience with Salesforce Service Cloud or other CRM tools is preferred
• Prior experience with pharmacy benefits, pharmacy prior authorizations, employer benefits, insurance, prescriptions, pharmacy billing, or experience at a pharmacy is preferred

What SmithRx Offers You :

• Competitive pay : $17 per hour
• Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life and AD&D Insurance
• 3 Weeks Paid Time Off
• 12 Paid Holidays
• Paid Parental Leave Benefits
• Flexible Spending Benefits
• 401(k) Retirement Savings Program
• Short-Term and Long-Term Disability
• Wellness Benefits
• Commuter Benefits
• Employee Assistance Program (EAP)
• Well-stocked Kitchen In Office Locations
• Professional Development and Training Opportunities
23 days ago