Bilingual Customer Service – Work From Home

Job Type: Bilingual Customer Service from home
Location: California work from home
Company: Abarca 

Position Description:

As the Rx Customer Service Specialist, you will manage all incoming and outgoing communications (calls, emails, and faxes) with pharmacies, patients, and prescribers. You will utilize Rx Platform and other resources as needed to meet the needs of callers.

Responsibilities:

• Manage all incoming pharmacy, beneficiary, and prescriber phone calls, emails, faxes, and web-based requests.
• Provide service-level standards established by CMS or client; 80% of calls should meet service level, abandonment rate should be less than 5%, and response time should be less than 30 seconds.
• Support for rejection, including overrides.
• Provide clients with the Coverage Determination status, including exceptions and appeals.
• Administrative PAs- Document PA request inquiries, issues, status, and resolutions according to federal and departmental policies and company guidelines.
• Respond to inquiries and suggest corrective services regarding customer complaints, payment status, manual reversal requests, benefit and eligibility support, provider portal support, and price appeals.
• Following the established procedure, report identified issues to the appropriate department for investigation and correction.
• What you are composed of

Requirements:

• Associate Degree in Pharmacy Technician required.
• Three or more years’ experience in a pharmacy or member services call center, retail or hospital pharmacy setting.
• Outstanding oral and written communication abilities.
• Required is fluency in both Spanish and English.
• Active and current pharmacy technician certification.
• Knowledge of PBM, Medicare Part D, Commercial/Employer Plans, Insurance, Pharmacy, and/or healthcare.