Coverage Determination Specialist - Temp

📋 Description

• Review and respond to CD requests for Medicare and Commercial plans.
• Receive calls from pharmacies, physicians, and members on CD status.
• Initiate calls to physicians, pharmacies, and members for needed info.
• Generate calls, faxes, and letters for 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 (or equivalent).
• 3+ years customer service experience.
• Proficiency with Outlook, Excel, PowerPoint, Word.
• Rotating shifts, including nights, weekends, holidays.
• Fluent in English and Spanish (oral and written).
• Preferred: Certified Pharmacy Technician license; healthcare exp welcome.