Johnson Service Group (JSG) is seeking a Pharmacy Benefits Coordinator
Remote in California.
Days/hours: Monday- Friday 9:00am- 5:30pm
Hourly pay: $26.00
DUTIES AND RESPONSIBILITIES
Customer Service
• Ability to respond to a wide-variety of member questions via telephone, e-mail and written correspondence regarding prescription drug benefits in a confidential, professional and ethical manner.
• Assist Benefits Coordinator II with coordinating intake and processing of Prior Authorization Requests.
• Provide support to Benefits Coordinator II with training CSRs to handle customer service inquiries.
• Assist the Benefits Coordinator II in developing policies and procedures for our customer service agents.
• Provide assistance to Benefits Coordinator II and Supervisor in resolving all escalations in a timely manner in order to meet our Service Level Agreements.
• Responsible for the PBM customer service Help Desk for day-to-day tasks. Call Tracking, after hours voicemail, customer service e-mails, direct member reimbursements, FDA recalls etc.
• Provide the Benefit II coordinator support to develop client-facing reporting and communications.
• Assist the Benefit II coordinator Implement PBM client management activities to achieve maximum revenue attainment, compliance to client plan documents, and patient participation for contracted business arrangements with clients, brokers, and payer organizations.
• Responsible for implementing “white glove” customer service expectations for the PBM.
Operations
• Achieve service level targets with our e-mail box, call-tracking episodes, organizing documents in the H drive, prior authorization invoices, and other areas of pharmacy operations.
• Utilize creative methods to understand how our customer’s perceive their interactions with Pinnacle Rx Solutions and the process for getting their medications.
• Support leadership in researching new business opportunities.
• Provide suggestions and contribute to workflow improvements.
• Contribute to team of highly skilled and talented experts who maintain the current reporting environment and work to continually improve it by delivering operational reporting products, including critical metric reporting, performance dashboards, work-in-progress trackers and forecasting.
• Back-up and assist the Pharmacy Benefit Analyst II in performing process Improvements, reporting and analytics, project management, and quality assurance activities
Other
• Utilize all capabilities to satisfy one mission — to enhance the competitiveness and profitability of our members. Do everything possible to help members succeed by being curious and striving to understand what others are trying to achieve, planning, and executing work helpfully and collaboratively. Be willing to adjust efforts to ensure that work and attitude are helpful to others, being self-accountable, creating a positive impact, and being diligent in delivering results.
• Focus efforts on quality and quantity of product deliverables as well as resourcing and project management in a fast paced and challenging environment.
• Ensure application compliance while creating an environment for innovation and growth.
• All other duties as assigned.
QUALIFICATIONS
• High school education or equivalent and one to three years of experience in Pharmacy Benefit Management or related fields.
• Pharmacy Technician Certification Board National Certification (PTCB)
• Intermediate knowledge of prescription benefits and products, and pharmacy claims.
• Patient Care oriented with ability to set priorities and meet required turn-a-round time frames.
• Intermediate knowledge of Microsoft Office Suite including word-processing and spreadsheet end-user software.
• Excellent written and oral communication skills, as well as interpersonal skills. • Good skills for project-based tasks.
• Basic ability using spreadsheet software, particularly, Excel's pivot tables, v-lookups, and other advanced formulas.
• Intermediate ability to research root cause, analyze impact, and report to leadership.
• Demonstrated ability to express complex technical concepts and processes effectively to senior leadership
• Analytical thinking skills and problem-solving capabilities.
• Availability to work weekend & evening coverage.
** Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law.