Associate Rx Customer Service Specialist

📋 Description

• Manage calls, emails, faxes, and web requests from pharmacies and prescribers.
• Meet CMS/client service levels: 80% in SLA, <5% abandon, <30s.
• Provide rejection support, including overrides.
• Provide Coverage Determination status with exceptions/appeals.
• Document PA requests, issues, status, and resolution per policies.
• Address customer complaints; assist with payments, reversals.
• Benefits/eligibility support and provider portal help; price appeals.
• Escalate issues to the appropriate department for investigation.

🎯 Requirements

• Associate’s Degree in Pharmacy Technician, or equivalent experience.
• 1+ year in Pharmacy or Member Services Call Center.
• Excellent oral and written communication; bilingual Spanish/English required.
• Remote work: stable internet; HIPAA/PHI compliant workspace.
• Available 40 hrs/week; Mon-Sun including holidays; 8am-8pm AST shifts.
• Active Pharmacy Technician License preferred.
• Experience in PBM, Medicare Part D, or health plans.