Coverage Determination Specialist

Added
2 hours ago
Type
Full time
Salary
Salary not provided

Related skills

cms excel microsoft office pharmacy pharmacy technician

๐Ÿ“‹ Description

  • Review and respond to CD requests for Medicare/Commercial plans.
  • Answer calls from pharmacies, physicians, and members on CD status.
  • Call physicians/pharmacies/members when more info is needed.
  • Send calls, faxes, or letters about CD resolutions.
  • Document CD inquiries and resolutions per policies.
  • Create new cases for Medicare/Medicaid or Commercial plans.

๐ŸŽฏ Requirements

  • Associate degree in Pharmacy Technician.
  • 3+ years in customer service.
  • Experience with Microsoft Office tools: Outlook, Excel, PowerPoint, Word.
  • Rotating shifts incl. nights, weekends, holidays.
  • Excellent oral and written comms; English & Spanish required.

๐ŸŽ Benefits

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