As one of the largest pharmacy benefits managers in the United States, UnitedHealth Group provides a professional culture where you're empowered and encouraged to exceed the expectations of our members, with better schedules than retail and more reach than any hospital. Join us and start doing your life's best work.(sm) The Pharmacy Support Specialist will make outbound calls to members and physicians to improve medication adherence and other pharmacy related quality metrics. Responsible for gathering prescription refill orders and providing excellent customer service as well as troubleshooting any pharmacy related issues. Please note: This position is office based off of Northwest Parkway in San Antonio, TX. Our office hours rotate M-F 8 am - 5 pm and 9 am - 6 pm. One 4 hour Saturday shift every 2-3 months is required. Primary Responsibilities: Conduct a high volume of outbound calls to members to discuss reasons for non-compliant to medication(s), schedule pharmacy telephonic appointments, and/or obtain important follow up information from providers May answer inbound calls from members and assists them with their inquiries. Routes calls to appropriate department if necessary Follows system scripting and validates member demographic information Documents the provider or member's record with accurate information obtained on the call Performs desk and on-site review of all claims documentation to validate correct billing and that payment made to contracted pharmacies is supported and appropriate Provides support to internal staff, subcontractors and providers with respect to Medicare drug related issues Participates in and contributes to the overall pharmacy quality improvement initiatives Collects and maintains eligibility information in an appropriate and confidential manner Exhibits excellent phone and communication skills while providing complete and accurate information to members Adheres to assigned schedule and quality metrics Uses a multi-lined telephonic system to answer calls regarding eligibility requirements and medication refill orders Follows all policy and procedures for Medication Adherence Initiative Performs all other related duties as assigned
Required Qualifications: Certified Pharmacy Technician (CPhT) High School Diploma or GED 2+ years of experience in pharmacy Extensive knowledge of the Medicare Part D, particularly the pharmacy record review, claims, billing and reimbursement rules Working knowledge of HIPAA Privacy and Security Rules and CMS security requirements Familiarity with the adjudication process and third party insurance rejections Working knowledge of Medicare Part D coverage guidelines and payment methodologies General writing skills and ability to produce work free from typographical or spelling errors Working knowledge of Microsoft Office, Internet and e-mailPreferred Qualifications: BilingualCareers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 90,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm) Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: Pharmacy Technician, Support Specialist, San Antonio, CPhT, San Antonio, Texas, TX, WellMed, UnitedHealth Group, UHG, UnitedHealthcare, UHC
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.