Rx Customer Service Specialist
US
Posted on 4/4/2023
INACTIVE
Abarca Health

501-1,000 employees

Personalized healthcare technology solutions
Company Overview
Abarca is on a mission to revolutionize healthcare. The company believes that with smarter technology pharmacy benefits can be redefined. Through a combination of aggressive pharmacy network design, the right formulary and clinical programs, rebates, and competitive admin fees, Abaraca helps payers minimize costs while maximizing the health and healthcare experience for members.
Financial Services
Data & Analytics

Company Stage

N/A

Total Funding

N/A

Founded

2005

Headquarters

San Juan, Puerto Rico

Growth & Insights
Headcount

6 month growth

9%

1 year growth

12%

2 year growth

25%
Locations
Remote
Experience Level
Entry
Junior
Mid
Senior
Expert
Desired Skills
Communications
Customer Service
Requirements
  • Pharmacy Technician Associate Degree preferred. (In lieu of a degree, equivalent relevant work experience may be considered.)
  • Active Pharmacy Technician License
  • 1+ years of experience working in a Pharmacy or Member Services Call Center, Retail or Hospital Pharmacy Setting
  • Excellent oral and written communication skills, bilingual fluency in Spanish and English is required
  • We are proud to offer a flexible hybrid work model which will require certain on-site workdays (Puerto Rico Location Only)
  • Must be able to access and navigate each department at the organization's facilities
  • Sedentary work that primarily involves sitting/standing
Responsibilities
  • Manage all incoming calls, emails, faxes and web-generated requests from pharmacies, beneficiaries, and prescribers
  • Provide service-level standards set by Centers for Medicare & Medicaid Services (CMS) or by client
  • Rejection support, including overrides
  • Provide Coverage Determination status to clients including exceptions and appeals
  • Administrative Pre-Authorizations Document, Pre-Authorizations request inquiries, issues, status, and resolution in accordance with federal and department and company policies and guidelines
  • Answer questions and recommend corrective services to address customer complaints, payment status, manual reversal requests, benefit and eligibility support, provider portal support and response to price appeals
  • Report identified issues to the appropriate department, for investigation and correction, following the established procedure
Desired Qualifications
  • Experience in PBM, Medicare Part D, Commercial/Employer Plans, Insurance, Pharmacy, and / or healthcare