A place that gives you opportunity and takes your breath away.

Job Summary

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.

Job Duties

• Maintains understanding of all policies and procedures related to the pharmacy benefit.
• Provides the highest level of customer service and support to members and physicians.
• Adheres to all regulatory standards.
• Works with Pharmacists to resolve clinical issues with providers in a timely manner.
• Documents accurately all inquiries and prior authorization requests according to departmental policy.
• Determines appropriateness of pharmacy benefits under corresponding lines of business.
• Contacts providers and members to communicate the details of service, requests additional information and resolves outstanding matters.
• Updates current pharmacy benefits and serves as a facilitator to team members.

Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.

Position Details

Work at Home requirements:

To ensure a productive and secure remote work environment, the following conditions must be met:

• Quiet, Dedicated Workspace: A private, distraction-free area within your home to support focused work.
• Adequate Workstation Setup: Sufficient space to accommodate all employer supplied equipment, including monitors, keyboard, and other peripherals.
• High-Speed Internet Connection:

Connection Type: Cable modem only (DSL, wireless cellular, and satellite services are not permitted).

Minimum Speed Requirements:

• Download: 75 Mbps
• Upload: 25 Mbps
• Ping: Less than 150 ms
• Jitter: Less than 30 ms
• Connectivity: The computer must be connected via Ethernet cable. Wi-Fi is not permitted unless a Virtual Private Network (VPN) is used to secure the connection.

Education

High School Diploma or Equivalent (GED)- (Required)

Experience

Minimum of 2 years-Customer Service (Required)

Skills

Customer Service; Customer Support Policies, Standards And Procedures; Communication; Customer Retentions

About Geisinger

Founded more than 100 years ago by Abigail Geisinger, the system now includes ten hospital campuses, a 550,000-member health plan, two research centers and the Geisinger Commonwealth School of Medicine. With nearly 24,000 employees and more than 1,700 employed physicians, Geisinger boosts its hometown economies in Pennsylvania by billions of dollars annually. Learn more at geisinger.org or connect with us on Facebook, Instagram, LinkedIn and Twitter.

Equal Opportunity Employer

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.

Our Vision & Values

Everything we do is about making better health easier 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.

SAFETY: We provide a safe environment for our patients and members and the Geisinger family.

Our Benefits

We offer healthcare benefits for full time and part time positions from day one, including vision, dental and prescription coverage.