[Hiring] Pharmacy Customer Service Representative @UnitedHealth Group

Role Description

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.

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.
• Preparing prior authorizations for submission.
• Following up on prior authorization outcomes.
• Addressing issues and handling concerns from other corresponding departments.

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, conducted virtually from your home, with hours from 9:00 am - 5:30 pm EST, Monday - Friday.

Primary Responsibilities:

• Handle initiating PA requests.
• Validate insurance types (Medicaid, Medicare, Commercial, etc.).
• Access 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.
• Enter notes/information into pharmacy processing system.
• Focus on patient care and quality assurance.

This role is equally challenging and rewarding, requiring fluency in computer navigation and toggling while confidently and compassionately engaging with the caller.

Qualifications

• 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.
• Ability to attend training from 9:00 am - 5:30 pm EST, Monday - Friday for 3 weeks.
• Ability to work full-time with flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00 am - 7:00 pm CST.

Requirements

• 1+ years of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools.
• Experience in pharmacy or healthcare.
• Prior Authorization Experience.
• Knowledge of insurance and third-party billing systems.
• General knowledge of pharmacy laws, practices, and procedures.

Soft Skills

• Demonstrated ability to listen skillfully, collect relevant information, build rapport, and respond to customers in a compassionate manner.
• Maintain strict confidentiality and adhere to all privacy and security regulations when handling sensitive information.
• Ability to manage multiple tasks and set priorities.
• Ability to establish and execute action plans; able to share your past successes.
• Ability to be diplomatic when faced with conflict, and always communicate in a professional and courteous manner.
• Ability to produce quality results with a detail-oriented focus.

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase.
• 401k contribution (all benefits are subject to eligibility requirements).

Application Deadline

This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.