CommunityCare · 21 hours ago
Pharmacy Technical Support Specialist
Tulsa, OK
Full-time
Onsite
Entry Level
2+ years expCommunityCare is seeking a Pharmacy Technical Support Specialist who will provide technical and customer service support for pharmacy benefits. The role involves processing prior authorizations and resolving pharmacy-related complaints while ensuring compliance with CMS and State regulations.
Health CareHealth Insurance
Responsibilities
Telephone support for pharmacies and members related to pharmacy benefits for the HMO product
Provides resolution for various types of phone calls including, but not limited to referral, authorization, and step therapy protocols between physicians, pharmacies and members for the HMO product
Resolve claims adjudication issues related to pharmacy
Responsible for processing prior authorizations for medications
Work may require overtime to meet deadlines. Work may also involve dealing with members who are disgruntled or upset
Performs other duties as assigned
Qualification
Required
Basic punctuation and grammar skills
Ability to function under pressure
Proficient in Microsoft applications
Ability to work independently and apply good judgment
Ability to maintain and preserve information of highly confidential nature
Possess strong oral and written communication skills
Capable of project management from beginning to completion
Successful completion of Health Care Sanctions background check
High school diploma or equivalent
Two years' experience in managed care pharmacy benefits, pharmacy tech or related discipline
Basic understanding of Health Plan Industry
One year customer service experience required
Preferred
Previous customer service experience in a Medicare Advantage plan
Company
CommunityCare
CommunityCare is dedicated to providing high-quality, cost-effective health care management services in the communities it serves.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Rusty Wyrick
Senior Vice President, Chief Technology and Transformation officer
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