Job Description
200 Ballardvale St, Wilmington, Massachusetts, 01887, USA
Description
Ametros is changing the way individuals navigate healthcare by providing them with the tools and support necessary to make educated decisions on how to spend their medical funds. Ametros's team works closely with patients, insurers, employers, attorneys, brokers, medical providers, and Medicare to create a seamless experience for our clients. Our flagship product is revolutionizing the way funds from insurance claim settlements are administered after settlement. Ametros continues to innovate, bringing new solutions to the market with the goal of simplifying healthcare for our clients. We make managing medical funds safe, effortless, and cost effective for everyone.
Schedule:
M-F (shift within 8am-8pm EST), with the ability to work some weekends/holidays
The Opportunity:
We are seeking a Rx Specialist to primarily provide support to the Authorizations team within the Member Services Department. The ideal candidate will be comfortable and familiar with prescription terminology and authorization practices. Our company is extremely passionate and dedicated to providing superior service. If you thrive in a fast-paced innovative environment that emphasizes individual accountability with the support of a team structure, come join us!
Your Day-to-Day:
Monitor and resolve all pharmacy rejected claims within the established turnaround times and in compliance with Medicare and regulatory requirements.
Follow-up on authorization requests in a timely fashion.
Contact members to obtain necessary approval on rejected pharmacy claims.
Contact PBM as needed to resolve any complex pharmacy issues.
Document all communication, upload appropriate documents to internal database, and document clear concise notes in our database to ensure accounts are up-to-date.
Proactively identify issues, and work towards a fast resolution.
Act in compliance with security and HIPAA policies and procedures.
Other duties as assigned.
Requirements
What you bring to the team:
Nationally Certified Pharmacy Technician & State Licensed Pharmacy Technician
2+ years’ experience in a call center and/or pharmacy setting
Thorough understanding & proficient use of customer service best practices and techniques in the Pharmacy Benefit industry.
Working knowledge of healthcare information systems and knowledge of Rx products and pharmacy services.
Ability to problem solve and handle customer conflicts effectively.
Strong interpersonal and communication skills.
The estimated salary range for this position is $23.00 to $25.00 per hour. Actual salary may vary up or down depending on job-related factors which may include knowledge, skills, experience, and location. In addition, this position is eligible for incentive compensation.
#LI-BB1
#LI-Remote
In addition to our benefits package, employees have the opportunity to get involved with engagement, diversity, and philanthropic initiatives from their first day working with us to help us achieve our goal of Limitless Inclusion for All. As Ametros Citizens, we work together to foster an environment of limitless inclusion and belonging that encourages, supports, and celebrates the diverse voices and backgrounds of our people, while energizing the passion and innovations to revolutionize our industry.
Ametros is an Equal Opportunity Employer
Apply Now
Description
Ametros is changing the way individuals navigate healthcare by providing them with the tools and support necessary to make educated decisions on how to spend their medical funds. Ametros's team works closely with patients, insurers, employers, attorneys, brokers, medical providers, and Medicare to create a seamless experience for our clients. Our flagship product is revolutionizing the way funds from insurance claim settlements are administered after settlement. Ametros continues to innovate, bringing new solutions to the market with the goal of simplifying healthcare for our clients. We make managing medical funds safe, effortless, and cost effective for everyone.
Schedule:
M-F (shift within 8am-8pm EST), with the ability to work some weekends/holidays
The Opportunity:
We are seeking a Rx Specialist to primarily provide support to the Authorizations team within the Member Services Department. The ideal candidate will be comfortable and familiar with prescription terminology and authorization practices. Our company is extremely passionate and dedicated to providing superior service. If you thrive in a fast-paced innovative environment that emphasizes individual accountability with the support of a team structure, come join us!
Your Day-to-Day:
Monitor and resolve all pharmacy rejected claims within the established turnaround times and in compliance with Medicare and regulatory requirements.
Follow-up on authorization requests in a timely fashion.
Contact members to obtain necessary approval on rejected pharmacy claims.
Contact PBM as needed to resolve any complex pharmacy issues.
Document all communication, upload appropriate documents to internal database, and document clear concise notes in our database to ensure accounts are up-to-date.
Proactively identify issues, and work towards a fast resolution.
Act in compliance with security and HIPAA policies and procedures.
Other duties as assigned.
Requirements
What you bring to the team:
Nationally Certified Pharmacy Technician & State Licensed Pharmacy Technician
2+ years’ experience in a call center and/or pharmacy setting
Thorough understanding & proficient use of customer service best practices and techniques in the Pharmacy Benefit industry.
Working knowledge of healthcare information systems and knowledge of Rx products and pharmacy services.
Ability to problem solve and handle customer conflicts effectively.
Strong interpersonal and communication skills.
The estimated salary range for this position is $23.00 to $25.00 per hour. Actual salary may vary up or down depending on job-related factors which may include knowledge, skills, experience, and location. In addition, this position is eligible for incentive compensation.
#LI-BB1
#LI-Remote
In addition to our benefits package, employees have the opportunity to get involved with engagement, diversity, and philanthropic initiatives from their first day working with us to help us achieve our goal of Limitless Inclusion for All. As Ametros Citizens, we work together to foster an environment of limitless inclusion and belonging that encourages, supports, and celebrates the diverse voices and backgrounds of our people, while energizing the passion and innovations to revolutionize our industry.
Ametros is an Equal Opportunity Employer