Pharmacy Team Customer Service Representative- Provider Service Contract Center

Job description

·  Job Description:

The Provider Services Contact Center Pharmacy Team staffs a helpdesk for pharmacy providers servicing members enrolled in Wisconsin Public Assistance programs including BadgerCare Plus, Medicaid, ADAP and SeniorCare Rx.  This team provides assistance with drug coverage rules, prior authorizations, coordination of benefits, and general drug billing policies and procedures.    

Responsibilities:

·  This position is responsible for validating member entitlement to benefits or services related to prescription drugs
·  Handling inquiries via phone, email or written correspondence.  Logging each case for the purpose of documenting, routing or dispatching an end-user or caller to the proper resources
·  Monitor the service event through completion for compliance
·  Manage the service requests of providers or customers through different access channels
·  Reviews customer feedback related to member entitlement & case management and analysis of statistics related to customer access (phone) & case management.
·  Provide resolution and feedback based on analysis
·  Additionally, this position may support healthcare administrative duties involving provider enrollment, call center and EDI support, member services, managed care support and other roles and duties in the support of our business

Education and Experience:

·  Ideal candidates will hold and maintain Pharmacy Technician Certification.  Noncertified applicants with adequate experience in the pharmacy field will be considered as well.
·  High School Diploma or equivalent; may hold 2 year post-high school Degree; may hold Bachelor’s degree.
·  Typically, 2-5 years of working experience in related fields.

Knowledge and Skills:

·  Office administrative experience and skills.
·  Ability to follow written policies, procedures and guidelines, and give feedback to leadership
·  Ability to access and retrieve information using a PC and basic understanding of Microsoft Office products.
·  Self-motivated with good time management and organizational skills.
·  Ability to read and interpret basic to moderately complex documents such as operating and maintenance instructions, procedure manuals, and government/healthcare guidelines.
·  Excellent written and verbal communication skills and customer service skills, including professional telephone skills.