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KPH Healthcare Services, Inc. Patient Benefit Specialist/Specialty Pharmacy Technician in Flowood, Mississippi

Overview

Scope of Responsibilities: Works under general supervision. Follows standard procedures to accomplish assigned tasks. May assist in orienting and training employees

Job Summary: Responsible for all aspects related to adjudication and billing of specialty prescriptions in a call center environment.

Responsibilities

Job Duties:

  • Responsible for monitoring adjudication queue(s)

  • Responsible for contacting members and prescribers on non-covered items

  • Facilitate prior authorization process for customers

  • Provide clinical services in TherigySTM

  • Customer service coverage for incoming calls and directing incoming calls

  • Provides resolution to customer service issues to ensure member satisfaction

  • Work with members to provide resolution to payment related issues on accounts/orders

  • Maintain and keep reasonable production as determined by supervisor

  • May assist in orienting and training new employees

  • Responsible for completing all mandatory and regulatory training programs

  • Perform other duties as assigned

Qualifications

Attendance Requirements:

  • Must be available, and on-time for scheduled work shifts.

  • Must be able to work nights and weekends as required.

Educational Requirements:

  • Minimum: High School Diploma or GED

  • Preferred: Pharmacy technician or related certification

Experience:

  • Past experience in a customer service related field

  • 6-12 months experience as a pharmacy technician

Special Conditions of Employment:

  • Drug test

  • Initial and continuous exclusion and sanction/disciplinary monitoring

  • Any and all additional eligibility requirements based on the specific position

Job Skill Requirements:

  • Broad knowledge of medications, physician orders, and pharmacy systems

  • Familiar with Enterprise billing options and practices surrounding claim submission

  • Strong communication skills

  • Outstanding customer service skills

  • Excellent organization skills

  • Ability to multitask and prioritize

  • Excellent computer and keyboarding skills

  • Successful completion of a pre-employment and/or random drug screening test

Required Training:

  • HIPPA Privacy Course

  • HIPPA Security Course

  • Fraud, Waste, and Abuse Course

  • MethGuard Course

  • HIPPA Privacy CE Mastery Exam

  • HIPPA Security CE Mastery Exam

  • Fraud, Waste, and Abuse CE Mastery Exam

  • MethGuard CE Mastery Exam

Behavioral Traits Required:

  • Cooperation: Must work harmoniously and effectively with fellow employees, supervisors and others you are in contact with

  • Initiative: Must work within supervision guidelines and assume additional responsibilities

  • Flexibility: Must be willing to work variable work schedules, nights and weekends, assist others as requested and available, and be willing to perform all assigned work

  • Adaptability: Must respond to new situations in a positive way, accept change, support new ideas, master new routines and grasp explanations, apply current knowledge in new environments and experiences

  • Involvement: Must enjoy the demands of the job and work with interest and enthusiasm

  • Customer Service: Must provide superior customer service (for Noble customers, fellow employees and business partners), listen attentively to their needs and respond appropriately

  • Safety: Must take care of equipment and employ good safety habits

  • Leadership: Must gain acceptance of ideas and accomplish goals through subordinates, peers and teams

Compensation

$17.50-19.37 an hour

The final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience and education.

KPH Healthcare Services, Inc. is a multistate organization and abides by all local, state and federal regulations as it pertains to minimum wage requirements .

Connect With Us! (https://kphcareers-kphhealthcareservices.icims.com/jobs/11219/patient-benefit-specialist-specialty-pharmacy-technician/job?mode=apply&apply=yes&in_iframe=1&hashed=-336031866)

Job Locations US-MS-Flowood

Posted Date 7 months ago (10/25/2023 3:49 PM)

Requisition ID 2023-11219

# of Openings 3

Category Customer Service/Support

Location : Location US-MS-Flowood

Min USD $17.50/Hr.

Max USD $19.37/Hr.

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