Coverage Determination Specialist - Temp

Added
less than a minute ago
Type
Full time
Salary
Salary not provided

Related skills

excel microsoft office powerpoint word outlook

πŸ“‹ Description

  • Review and respond to CD requests, including Medicare/Commercial plan adjudication.
  • Receive calls from pharmacies, physicians, and members about CD status.
  • Initiate calls to physicians, pharmacies and members when additional information is required.
  • Document CD inquiries, status, and resolution per policies.
  • Review faxes and emails and create new cases for Medicare/Medicaid or Commercial plans.
  • Support pharmacists in gathering information to support CD decisions.

🎯 Requirements

  • Associate degree in Pharmacy Technician (or equivalent work experience)
  • 3+ years of customer service experience
  • 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 is required.

🎁 Benefits

  • Certified Pharmacy Technician License is preferred.
  • Experience in healthcare or pharmacy setting is a plus.
  • E-Verify participation.
  • No visa sponsorship.
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