[Hiring] Pharmacy Benefits Investigation - BioPlus Specialty Pharmacy @Elevance Health

Role Description

The Pharmacy Customer Associate II is responsible for responding to basic customer questions via telephone and written correspondence regarding pharmacy retail and mail order prescriptions.

• Develops and maintains positive customer relations and coordinates with functions within the company to ensure customer requests are handled and resolved appropriately and in a timely manner.
• Interacts with internal and external customers (could include subscribers, providers, group or benefit administrators, physician offices, third party representatives, and other Blue Cross Plans) to provide claims, customer service, and/or membership support.
• Completes necessary research to provide proactive, thorough solutions.
• Displays ownership of service requests ensuring high quality resolution and follow-thru.
• Supports and guides the customer with their personal options and decisions and helps the customer become knowledgeable and confident about using technology, tools and resources available to them.

Qualifications

• Requires a HS diploma or equivalent and previous experience in an automated customer service environment; or any combination of education and experience which would provide an equivalent background.
• 2+ years of Specialty Pharmacy experience strongly preferred.
• Certified or Registered Pharmacy Technician preferred.
• Experience with pharmacy benefits investigation strongly preferred.
• Experience processing/interpreting pharmacy claims is very helpful.
• Experience with pharmacy prior authorizations and pharmacy billing is very helpful.
• Experience working with a variety of therapy types is very helpful.
• Strong critical thinking skills are a must for this position.

Requirements

• Location: This is a virtual eligible role. You must be within a reasonable commuting distance of one of our offices.
• Hours: 11:30 am - 8:30 pm, ET, Monday through Friday.
• Training: 5 Weeks, training will be conducted during regular business hours, 8:00 am - 5:00 pm or 9:00 am - 6:00 pm, ET.
• Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions.

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs (unless covered by a collective bargaining agreement)
• Medical, dental, vision benefits
• Short and long term disability benefits
• 401(k) + match
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources