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Customer Care Pharmacy Technician (Full-Time)

2 hours, 13 minutes ago
United States
Full-time
Junior
Customer Support
Customer and Technical Support
HIPAA
Apply Now
Capital Rx

Capital Rx

Capital Rx provides comprehensive health benefit management and transparent pharmacy benefit management solutions, integrating various healthcare services to support millions of plan members across diverse sectors.

Health Care Providers & Services
251-1K
Founded 2017
View All Jobs 39

Description

  • Serve as the primary point of contact for incoming member calls and prior authorization inquiries, escalating cases and intake notes to the Clinical Prior Authorization Team as needed.
  • Collect complete prior authorization requests from prescribers and members by asking drug-specific and client-specific clinical questions.
  • Advise callers on exception request options and provide status updates to prescribers, members, and pharmacies.
  • Triage and resolve incoming calls from members, prescribers, and pharmacies with professional phone etiquette and minimal supervision.
  • Support Customer Service Representatives by responding to member and pharmacy inquiries and stepping in based on demand.
  • Communicate issues and solutions to members, pharmacies, and internal stakeholders to ensure safe, high-quality resolutions.
  • Follow internal Standard Operating Procedures, HIPAA guidelines, Company policies, and the Capital Rx Code of Conduct.
  • Assist with onboarding and training of new team members or temporary staff as needed.
  • Support the Fraud, Waste, and Abuse program by reviewing pharmacy claims information and sharing findings with internal staff.
  • Meet departmental goals for schedule adherence, attendance, and quality monitoring.

Requirements

  • High school diploma or equivalent; associate or bachelor’s degree preferred.
  • Current National Certification as a Pharmacy Technician (CPhT) and a valid license required.
  • 2+ years of pharmacy technician experience in a clinical pharmacy, PBM, health plan, or related healthcare setting required.
  • 2+ years of customer service experience with strong listening, relationship-building, and written/verbal communication skills required.
  • Experience handling prior authorization requests or understanding prior authorization requirements preferred.
  • Ability to work independently in a remote, high-volume, fast-paced, metric-driven call center environment.
  • Proficiency with CRM systems, call center platforms, and Microsoft Office Suite.
  • Demonstrated ability to meet performance metrics, including call quality, resolution time, and customer satisfaction.
  • Maintain a secure, high-speed broadband internet connection at the remote location; 1 Gig plan required, and dial-up, satellite, WiFi, 5G, and cellular connections are not acceptable.
  • Must be open to working any shift; training hours are Monday through Friday, 9:00 am to 5:30 pm Eastern.
  • Bilingual Spanish highly preferred.
  • Medicare experience preferred.
  • Experience supporting pharmacy operations or benefits administration preferred.
  • Passion for healthcare, adaptability in a startup or high-growth environment, and commitment to diversity, equity, and inclusion are preferred attributes.

Benefits

  • Remote position with priority given to candidates in Hawaii.
  • Full-time opportunity.
  • Base salary of $28 USD per hour.
  • Equal employment opportunity and a workplace committed to diversity and inclusion.

Interested in this position?

Apply directly on the company website

Apply Now

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