[Hiring] Specialty Operations Pharmacy Technician @CenterWell

Role Description

The Specialty Operations Pharmacy Technician 2 supports Pharmacists in Specialty Rx medication preparation by dispensing Specialty Rx medications. The Specialty Operations Pharmacy Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

The Pharmacy Claims Representative 2 analyzes and answers inquiries regarding pharmacy claims adjudication, including method of payment, co-pay or deductible amounts, and/or reason for denial. Decisions are typically focused on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

• Adjudicates pharmacy claims and processes pharmacy claims for payment.
• Performs varied activities and moderately complex administrative/operational/customer support assignments.
• Performs computations.
• Typically works on semi-routine assignments.

Qualifications

• Must have an active license with the Board of Pharmacy in the appropriate state.
• Must be PTCB certified.
• 1+ year of claims processing, insurance or pharmacy experience.
• Must have strong MS Office skills as this role is report heavy.

Requirements

• Inbound/Outbound call experience.
• Customer service experience.
• Strong communication skills.
• Work at Home Requirements:
  • Self-provided internet service must meet a minimum download speed of 25 Mbps and an upload speed of 10 Mbps.
  • Wireless, wired cable or DSL connection is suggested.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• Travel: Occasional travel to Humana's offices for training or meetings may be required.

Benefits

• Medical, dental and vision benefits.
• 401(k) retirement savings plan.
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave).
• Short-term and long-term disability.
• Life insurance.
• Many other opportunities to support whole-person well-being.

Company Description

About CenterWell Pharmacy: CenterWell Pharmacy provides convenient, safe, reliable pharmacy services and is committed to excellence and quality. Through our home delivery and over-the-counter fulfillment services, specialty, and retail pharmacy locations, we provide customers simple, integrated solutions every time.

About CenterWell, a Humana company: CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high-quality healthcare that is accessible, comprehensive and, most of all, personalized.