Top 2 Advanced medical solutions Jobs

Pharmacy Technician
Advanced Medical Pricing Solutions —Phoenix, AZ
- Hybrid work
- Bilingual
- HIPAA
- Research
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Advanced Medical Pricing Solutions —United States
- Full-time
- Remote
- Customer service
- 5 years
- Writing skills
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Pharmacy Technician

Advanced Medical Pricing Solutions -
Phoenix, AZ

Quick Apply

Job Details

Qualifications

Health insurance policy knowledge
High school diploma or GED
Telephone systems
Multi-line phone systems
Medical terminology

Full Job Description

Description:

The Pharmacy Customer Service Advocate assists member, providers, and pharmacies with inquiries for member’s eligibility, claim status, precertification requirements, and claims coverage questions by phone, fax, email, and US mail, working independently within the scope of their duties. The Customer Service Advocate coordinates the handling of numerous daily, time-sensitive functions required to maintain an efficient workflow and direct all maters to a proper resolution.

Job Responsibilities:

Maintain HIPAA/PHI guidelines to ensure the confidentiality of all calls and documents
Interpret plan documents/plan guidelines
Determine eligibility by reviewing, researching, and analyzing information in the appropriate system
Use critical thinking and reasoning to manage workload with above average level
Maintain and enter information into systems as information is received
Forward all records to the appropriate parties
Record and respond to calls/emails/faxes from Member, Providers, and Pharmacies
Maintain high level of knowledge to answer specific Pharmacy Plan Benefit information or sharing guideline related questions
Review issues as they arise
Serve as a role model in demonstrating core values of customer service
Provide timely and thorough responses to internal and external customers
Escalate difficult issues to the appropriate party
Provide exceptional customer service for incoming/outgoing calls
Propose process improvements to enhance customer service satisfaction
Ensure compliance with service standards
Develop and execute plans to meet established goals
Provide continuous feedback to strengthen and optimize quality performance
Work cross-departmentally to improve or streamline procedures
Maintain up to date knowledge on industry trends and look for new data sources
Develop or improve current internal processes to improve overall quality
Accurate and complete documentation of all daily interactions
Special projects as assigned

Skills and Abilities:

Excellent verbal and written communication skills with high attention to detail
Excellent customer service skills
Strong analytical and problem-solving skills
Confident decision-making abilities

Advanced Medical Pricing Solutions (AMPS) provides market leading healthcare cost containment services for self-funded employers, public entities, brokers, TPAs, payers and many other entities. As we continue to grow, we look for driven professionals who share our core values.

We take a “one team” approach to keeping clients satisfied and engaged with our products and services for the long-term.

Demonstrated ability to work independently, prioritize workloads, multi-task effectively, and manage priorities to meet deadlines

Requirements:

Education and Experience:

High school diploma or equivalent required
PBM Experience
Minimum 2 years customer service or claims experience in the Health Insurance Industry
Preferred experience in Call Center Customer Service
Preferred experience in Pharmacy Tech
Must have experience in handling multi-line telecommunication systems and electronic documentation software
Knowledge of medical/pharmaceutical terminology required
Health Insurance/Eligibility and Benefit knowledge required
Prior authorization experience preferred
Bilingual a plus

Physical Requirements:

Indoor office environment with moderate noise
Hybrid position
First 90 days in office for training
Intermittent physical effort may include lifting to 25 lbs., walking, stopping, kneeling, crouching or crawling may be required
Frequent sitting, use of a keyboard, reaching with hands and arms, talking, and hearing approximately 70% of the time; 30% or less time is spent standing
Normal vision abilities required including close vision and ability to adjust focus
Travel up to 10% of the time may be required

Quick Apply

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