The Call Center Pharmacy Technician provides telephone support to patients, providers, and insurance companies, managing prescription authorizations, prior authorizations, and benefit verifications in compliance with Puerto Rico regulations. This role focuses on delivering accurate, empathetic, and efficient service, ensuring proper documentation of each interaction and timely resolution of medication-related inquiries. The technician must maintain clear communication, effective call control, and a service-oriented approach, with the goal of ensuring high-quality care and patient satisfaction.
RESPONSABILITIES AND DUTIES
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Handle inbound calls from pharmacies.
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Manage administrative pre-authorizations, including cases related to travel, costs, and other scenarios defined during the training process, ensuring compliance with established guidelines.
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Verify insurance eligibility, benefits, and coverage in the corresponding systems.
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Validate, enter, and process medical prescriptions in the assigned platforms, as well as create cases in RxPath.
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Provide basic guidance on medications, prescription status, and related processes.
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Accurately and promptly document all interactions in the systems.
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Efficiently manage multiple systems and databases simultaneously.
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Meet quality metrics, productivity standards, service levels, and response time requirements.
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Maintain information confidentiality in accordance with HIPAA and applicable regulations.
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Identify and escalate cases requiring additional intervention or pharmacist review.
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Follow company policies, procedures, and established guidelines.
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Notify supervisor of any situation that may affect operations, whether related to clients or employees that may impact the proper functioning of the company.
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Any other task designated by the immediate supervisor or manager, not limited to the above.
WORK EXPERIENCE REQUIREMENTS
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Minimum 6 months of experience as a Pharmacy Technician and in customer service in a Call Center (preferred).
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Basic knowledge of pharmaceutical processes and patient care.
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Experience handling high call volume (preferred).
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Knowledge of pharmaceutical terminology and medications.
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Pharmacy systems proficiency.
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Ability to work with multiple systems simultaneously.
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Basic knowledge of health insurance benefits (Medicare, Medicaid, commercial plans).
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Proficiency in technology tools and computer equipment.
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Good keyboard management and data entry skills.
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Excellent verbal and written communication skills with clear diction.
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Active listening skills and telephone contact abilities.
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Customer service orientation and patient empathy.
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Ability to identify and respond to customer needs.
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Ability to manage pressure and high workload.
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Attention to detail and accuracy in information handling.
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Adaptability to interact with different customer profiles.
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Teamwork and collaboration.
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High sense of responsibility, ethics, and professionalism.
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Availability to work rotating schedules and shifts.
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Bilingual — Spanish and English (spoken and written) preferred.
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Active registration as a Pharmacy Technician with the Puerto Rico Board of Pharmacy Examiners (Law 247-2006). Valid PTCB (Pharmacy Technician Certification Board) or ExCPT certification.
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Courses or certifications related to the field.
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Work is primarily sedentary, approximately 7 to 8 hours, to successfully fulfill essential functions.
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Constant exposure to computerized equipment to perform job functions.
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Vision, speaking, and hearing are required to execute functions and be understood.
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Must be available to work overtime when operational needs require it.
Affirmative Action Plan Statement / Equal Employment Opportunity
Insight Communications, Corp. offers equal employment opportunities to all employees and applicants and strictly prohibits discrimination, harassment, or retaliation based on race, color, religion, age, sex, national origin, disability status, genetic information, protected veteran status, sexual orientation, gender identity or expression, marital status, pregnancy, political beliefs, or any other status protected by applicable federal, state, or local laws.
This policy applies to all terms and conditions of employment, including recruitment, hiring, placement, promotion, termination, layoffs, transfers, leaves of absence, compensation, training, and all employment-related decisions.
Employees who believe they have been subjected to discrimination, harassment, or retaliation are encouraged to report such incidents immediately to their supervisor, Human Resources department, or through any established company complaint channels. Insight Communications, Corp. is committed to promptly investigating and addressing complaints confidentially and impartially.
