Abarca Health

Compensation

Full Description

Description: • Manage all incoming calls, emails, faxes and web-generated requests from pharmacies, beneficiaries, and prescribers. • Provide service-level standards set by CMS or by client; 80% of calls should fall within service level, less than 5% abandon rate and speed to answer should be less than 30 seconds. • Rejection support, including overrides. • Provide Coverage Determination status to clients including exceptions and appeals. • Administrative PAs- Document PA request inquiries, issues, status, and resolution in accordance with federal and department and company policies and guidelines. • Answer questions and recommend corrective services to address customer complaints, payment status, manual reversal requests, benefit and eligibility support, provider portal support and response to price appeals. • Report identified issues to the appropriate department, for investigation and correction, following the established procedure. Requirements: • Associate’s Degree in Pharmacy Technician (in lieu of a degree, equivalent, relevant work experience may be considered). • 1+ years of experience working in a Pharmacy or Member Services Call Center, Retail or Hospital Pharmacy Setting. • Excellent oral and written communication skills, bilingual fluency in Spanish and English is required. • Must be available to work 40 hours per week, Monday through Sunday—including holidays—with flexibility to work any 8-hour shift within our standard business hours of 8:00 AM to 8:00 PM AST. Benefits: • We are proud to offer work remotely, must have a stable, secure, and efficient internet connection. Dedicated workspace observing HIPAA and PHI protocols.