Coverage Determination Specialist

Added
26 days ago
Type
Full time
Salary
Salary not provided

Related skills

customer service pharmacy technician microsoft excel microsoft outlook microsoft powerpoint

๐Ÿ“‹ Description

  • Review and respond to all CD requests and pending Medicare/Commercial claims.
  • Receive calls from pharmacies, physicians, and members about CD status.
  • Initiate calls to physicians, pharmacies, and members when more info is needed.
  • Generate calls, faxes, or letters to pharmacies/physicians about CD resolutions.
  • Document CD inquiries, issues, status, and resolutions per policies.
  • Review faxes/emails and create new cases for Medicare/Medicaid or Commercial plans.

๐ŸŽฏ Requirements

  • Associate degree in Pharmacy Technician (or equivalent experience).
  • 3+ years of experience in customer service.
  • Experience with Microsoft Office tools (Outlook, Excel, PowerPoint, Word).
  • Available to work rotating shifts, including nights, weekends, and holidays.
  • Excellent oral and written communication; English and Spanish fluency required.

๐ŸŽ Benefits

  • Certified Pharmacy Technician License is preferred.
  • Experience in healthcare or pharmacy setting is a plus.
Share job

Meet JobCopilot: Your Personal AI Job Hunter

Automatically Apply to Healthcare Jobs. Just set your preferences and Job Copilot will do the rest โ€” finding, filtering, and applying while you focus on what matters.

Related Healthcare Jobs

See more Healthcare jobs โ†’