JOB TITLE: Pharmacy Customer Service Representative
LOCATION: Geisinger Health Plan, Hughes
DEPARTMENT: GHP Pharmacy Services
WORK SCHEDULE: Days
WORK TYPE: Full Time (1.0 FTE)
Assists Pharmacy Customer Service leadership in processing provider, and member prior authorization requests. Works with the pharmacy team in implementing policies to manage pharmacy benefits of the Geisinger Health Plan.
Responsible for attaining the highest level of customer satisfaction while providing feedback on the progress of defined goals essential to success of the Geisinger Health Plan.
Proficient in handling pharmacy prior authorization requests for GHP Family, but not limited to all other lines of business including Commercial and Gold business.
Excellent communication, problem solving and customer service skills within a team atmosphere. Demonstrates excellent organization and time management skills and ability to work independently. Demonstrates the ability to multi-task. Demonstrates good verbal and written skills and ability to work with all levels of Health Plan personnel. This position demands thorough knowledge of products and processes in order to respond to member and physician requests.
Must be able to maintain member/provider confidence by helping to protect the confidentiality of information coming into and being disseminated out of the department in accordance to HIPAA guidelines.
Reports directly to the Team Leader, Pharmacy Customer Service Operations and works in cooperation with the Geisinger Health Plan staff.
COMPETENCIES AND SKILLS:
Demonstrates excellent communication skills to include oral, written, audio and electronic communication skills, with a willingness to learn and function in a team environment.
Demonstrates excellent organization and time management skills and ability to work independently.
Demonstrates keyboarding proficiency.
Demonstrates knowledge of medical terminology pertaining to pharmaceuticals and operational knowledge of benefit plans.
Demonstrates thorough knowledge of products and processes to respond to prior authorization requests from members and physicians.
Demonstrates experience with the following software programs/systems preferred: CSI, MedAccess, Epic, Outlook, and Microsoft Office products.
EDUCATION AND EXPERIENCE:
High school degree or equivalent required.
Minimum two years’ experience in a customer service role required, preferably in a hospital, clinic, or insurance environment.
WORKING CONDITIONS/PHYSICAL DEMANDS:
Work is typically performed in an office environment.
The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.
OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
ABOUT GEISINGER: Geisinger is a physician-led health system comprised of approximately 30,000 employees, including nearly 1,600 employed physicians, 13 hospital campuses, two research centers, and a 583,000-member health plan Geisinger is nationally recognized for innovative practices and quality care. Geisinger serves more than 3 million people in central, south-central and northeast Pennsylvania and also in southern New Jersey with the addition of National Malcolm Baldridge Award recipient AtlantiCare, A member of Geisinger. In 2017, the Geisinger Commonwealth School of Medicine became the newest member of the Geisinger Family.
We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. * Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. For more information, visit www.geisinger.org, or connect with us on Facebook, Instagram, LinkedIn and Twitter.
** Does not qualify for J-1 waiver. We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
*Domestic partner benefits not applicable at Geisinger Holy Spirit.
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh Food
Farmacy, a program that delivers life-saving healthy alternatives to patients with diabetes. With additional tools like our MyCode Community Health Initiative, one of the first health system genome sequencing
programs, and our new asthma app suite that we developed in partnership with AstraZeneca, it’s no wonder we’re ranked one of the Top 5 Most Innovative Healthcare Systems by Becker's Hospital Review. We continually work towards continuous improvement in a culture where everyone has a voice and firmly believe that better begins with all of us.
Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13 hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers.
What you do at Geisinger shapes the future of health and improves lives – for our patients, communities, and you.