PHARMACY MEDICARE SPECIALIST (CUSTOMER SERVICE) - EXTENDED HOURS

Pharmacy Medicare Specialist (Customer Service) - Extended Hours page is loaded Pharmacy Medicare Specialist (Customer Service) - Extended Hours

Pharmacy Medicare Specialist (Customer Service) - Extended Hours

locationsSelectHealth - Murray time typeFull time posted onPosted Today job requisition idR33021 Job Description :

The Pharmacy Medicare Specialist I is responsible for the day-to-day operations of Medicare Part D. This position provides superior customer service in response to all inquiries and questions for members, providers, employer groups, facilities, and other departments and teams. Job Essentials

Receives incoming calls from members, providers, facilities, employer groups, and other departments. Provides superior customer service that is consistent with policies, company values, and quality standards.

Maintains the confidentiality of member's personal information to be compliant with internal confidentiality policy.

Maintains customer history in member tracking using correct codes and detailed comments.

Utilizes several applications and tools to respond to inquiries regarding pre- and post-enrollment, benefits, cost sharing, Medicare forms, True Out Of Pocket (TrOOP) status, and the formulary transition process.

Assists Medicare members with the Part D grievance, coverage determination (including exceptions), and appeals process.

Required to meet all department standards pertaining to call statistics, production, documentation, and quality and accuracy.

Meets department and CMS standards for preauthorization and override for members and providers.

Follows established CMS guidelines to complete Medicare pre-authorizations, which include member and provider notification standards.

Extended Hours positions are for working hours that fall outside of the department's regular hours of operations (Regular Hours of Operations : Monday-Friday, 7AM to 9PM and Saturday, 9AM to 5PM)

Minimum Qualifications

One year of customer service experience in a managed or health care setting, which could include customer service representative, pharmacy technician, pharmacy, or medical benefits.

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Two years of experience in pharmacy insurance or health insurance.

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One year experience with Medicare.

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Meets transition requirements listed in Pharmacy Services Guidelines Experience with the SelectHealth authorization systems and various pharmacy plan benefits.

Preferred Qualifications

Bachelor's degree. Education must be obtained from an accredited institution. Degree will be verified.

Three years of professional experience with Medicare Part D.

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Computer skills with word processing, spreadsheet applications, and data base management.

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Professional attitude and behavior including the ability to handle stress well, work with a variety of health care professionals, and work through frequent interruptions.

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Excellent problem solving, autonomous decision making abilities, and ability to function with minimal supervision.

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Demonstrated excellent verbal and written communication skills.

Physical Requirements :

Interact with others requiring the employee to communicate information.

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Operate computers and other office equipment requiring the ability to move fingers and hands.

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See and read computer monitors and documents.

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Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.

Location :

SelectHealth - Murray Work City :

Murray Work State :

Utah Scheduled Weekly Hours :

40 Intermountain Healthcare is a team of more than 41,000 caregivers who serve the healthcare needs of people across the Intermountain West, primarily in Utah, Idaho, and Nevada.

We are an integrated, not-for-profit health system based in Salt Lake City, Utah, with clinics, a medical group, affiliate networks, hospitals, homecare, telehealth, health insurance plans, and other services, along with wholly owned subsidiaries including SelectHealth, Saltzer Health, and Intermountain Healthcare in Nevada.

Our mission is : Helping people live the healthiest lives possible.

Join our world-class team and embark on a career filled with opportunities, strength, innovation, and fulfillment.

Get In Touch

Introduce yourself to our Talent Acquisition team and we will get in touch if there is a role that seems like a good match.

We intentionally work toward an Intermountain Healthcare that reflects our diverse communities and provides culturally competent care, health equity, and a sense of belonging amongst all our caregivers (employees).

This is an important part of fulfilling our mission to help people live the healthiest lives possible. The three pillars of our work are talent experience with Intermountain (application, internship, development, etc.

community benefit, and care delivery.

Learn more about diversity at Intermountain,

The primary intent of this job description is to set a fair and equitable rate of pay for this classification. Only those key duties necessary for proper job evaluation and / or labor market analysis have been included.

Other duties may be assigned by the supervisor.

All positions subject to close without notice. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability or protected veteran status.

Women, minorities, individuals with disabilities, and veterans are encouraged to apply.

Thanks for your interest in continuing your career with our team!