PHARMACY SERVICE REP
Posted on: 2 Oct 2021
Molina, CO
Job Description
Job Summary
Handles provider phone calls regarding pharmacy claims processing in a call center setting. Satisfactorily resolve calls within expected response time standards.
Knowledge/Skills/Abilities
• Handles inbound pharmacy call volume.
• Responds to incoming calls mainly from providers, as required to meet departmental goals.
• Explains Point of Sale (POS) claims adjudication, state Medicaid policy/guidelines, and any other necessary information to providers, in a clear, precise, and professional manner.
• Records calls accurately in call tracking system.
• Maintains specific quality and quantity standards.
• Assists with process tasks & activities.
• Assists with clerical support services/tasks as delegated.
Job Qualifications
Required Education
High School Diploma or equivalent GED
Required Experience
1-2 years Medicaid experience in a community pharmacy
Required License, Certification, Association
Current Pharmacist Technician license
Preferred Experience
Medicaid pharmacy policy
Pharmacy POS claim processing
Molina Healthcare
Long Beach, CA
Molina Healthcare, Inc., a multi-state healthcare organization, provides managed health care services to low-income families and individuals under the Medicaid and Medicare programs and through the state insurance marketplaces. As of December 31, 2018, it served approximately 3.8 million members in 14 states and the Commonwealth of Puerto Rico, who are eligible for Medicaid, Medicare, and other government-sponsored health care programs. The company offers its health care services for its members through contracts with a network of providers, including physicians and physician groups, hospitals, ancillary providers, and pharmacies. Molina Healthcare, Inc. was founded in 1980 and is headquartered in Long Beach, California.
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IndustryHealthcare
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No. of Employees11, 000
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Website
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Jobs Posted261
