Coverage Determination Specialist

Added
less than a minute ago
Type
Contract
Salary
Salary not provided

Related skills

cms excel microsoft office powerpoint pharmacy technician

📋 Description

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

🎯 Requirements

  • Associate degree in Pharmacy Technician.
  • 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; fluency in English and Spanish required.
  • Certified Pharmacy Technician License is preferred.
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