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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in pharmacy benefit policies and procedures while providing exceptional customer service and support to members and healthcare providers. Capable of accurately documenting inquiries and managing prior authorization requests in compliance with regulatory standards.
Highest-signal resume keywords
Customer Service ExperiencePharmacy Benefit KnowledgeCommunication SkillsRegulatory Standards AdherenceCustomer Support Policies Knowledge
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Soft Skills
Communication SkillsCustomer Retention SkillsCustomer Service Skills
Certifications & Qualifications
High School DiplomaGED
Industry Keywords
Prior Authorization RequestsPharmacy BenefitsCustomer SupportClinical Issues ResolutionDocumentation
About the role
Key responsibilities & impact- Assist Pharmacy Customer Service leadership in processing provider and member prior authorization requests
- Work with the pharmacy team to implement policies for managing pharmacy benefits
- Maintain understanding of pharmacy benefit policies and procedures
- Provide customer service and support to members and physicians
- Work with pharmacists to resolve clinical issues with providers
- Accurately document inquiries and prior authorization requests
- Determine appropriateness of pharmacy benefits under corresponding lines of business
- Contact providers and members to communicate service details, request additional information, and resolve outstanding matters
- Update current pharmacy benefits and facilitate information for team members
- Provide weekend and holiday coverage
Requirements
What you’ll need- High School Diploma or Equivalent (GED) (Required)
- Minimum of 2 years of customer service experience (Required)
- Communication skills
- Customer retention skills
- Customer service skills
- Customer support policies, standards, and procedures knowledge
- Ability to work every 3rd week on-site in Danville, Pennsylvania
- Weekend and holiday coverage availability
- Ability to adhere to regulatory standards and organization policies and procedures
Benefits
Comp & perks- Healthcare benefits for full-time and part-time positions from day one
- Vision coverage
- Dental coverage
- Domestic partner benefits
- Collaborative, cooperative, and collegial work atmosphere
- Work from home arrangement with hybrid scheduling