Intermountain Healthcare Customer Service Specialist, Pharmacy Benefits - SelectHealth in Salt Lake City, Utah

Job ID:225979
Greater Salt Lake area
Details:

About Us

Being a part of Intermountain Healthcare means joining a world-class team of over 37,500 employees and caregivers while embarking on a career filled with opportunities, strength, innovation, and fulfillment. Our mission is: Helping people live the healthiest lives possible.

Our patients deserve the best in healthcare, and we deliver.

To find out more about us, head to our career site here .

PHARMACY BENEFIT SPECIALIST

Do you want to make a difference in someone’s life? Our mission is to help people live the healthiest lives possible. Do you want to work in an environment where you can focus on superior service? Our Pharmacy Benefits Specialist position offers you an opportunity to provide extraordinary customer service to SelectHealth members while educating them on their pharmacy benefits and the correct use of their plans.

Responsibilities: The Pharmacy Benefits Specialist (PBS) position is primarily responsible for answering phone calls from SelectHealth members, employers, providers, facilities, and other SelectHealth departments. The PBS assists customers promptly and accurately via telephone, email or chat with inquiries, requests, problem resolution, comments and feedback regarding pharmacy benefits and claims payments.

Why Join our Team?

Total Rewards:

  • Competitive compensation package – starting pay is $14.71/hour base (Level I) with the potential to move to $16.17/hour base (Level II) after 12 months, plus a monthly bonus
  • Additional pay for bilingual (Spanish-speaking) representatives
  • Shift differential pay for evenings and weekends
  • 401(k) plan with employer match
  • Paid time off
  • Paid holidays
  • Medical, dental, life and vision insurance

Additional Benefits of Working for SelectHealth

  • Live Well incentive program
  • UTA Transit pass discount
  • Tuition assistance
  • Employee referral bonus
  • On-site Gym
  • Jeans day on payday Fridays
  • Employee Discount Program
  • Outstanding employee rewards
  • Recognition program
  • Collaborative/inclusive culture
  • Wellness program
  • Employee Assistance Program (EAP)
  • Education and development opportunities
  • Employee appreciation week
  • Monthly massages

Training

  • Six weeks paid training
  • Training hours: Monday through Friday, 8:30 a.m. to 5:00 p.m.

Shift Expectations

  • Department hours: 7:00 am to 8:00 pm
  • One closing shift per week (11:30 am to 8:00 pm)
  • One rotating Saturday shift per month (9:00 am to 2:00 pm)

Minimum Requirements

Candidate may be hired as a Pharmacy Benefits Specialist I or II depending on experience.

Pharmacy Benefits Specialist I

  • One year combined experience in any of the following: medical/pharmacy claims processing; health benefit coordination; customer service experience; pharmacy technician experience.
  • Experience utilizing word processing software.

Pharmacy Benefits Specialist II

  • Nine months as a Pharmacy Benefits Specialist I and meeting minimum performance and transition standards outlined in Pharmacy Services Guidelines or current national pharmacy technician certification.
  • Demonstrated capability of processing or communicating the following types of pharmacy benefits: coordination of benefits, direct member reimbursements, coinsurance benefits, and mail order prescriptions.

Physical Requirements

  • Manual dexterity, hearing, seeing, speaking.

Preferred Requirements

  • Call center or strong telephone customer service experience
  • Pharmacy technician education, training, or work experience
  • Health insurance experience
  • Demonstrated excellent verbal and written communication skills individually and within groups.
  • Health care customer service and claims processing experience.

Essential Job Duties

  • Processes and/or communicates multiple types of pharmacy benefits including coordination of benefits, direct member reimbursements, coinsurance benefits and mail order prescriptions.
  • Receives incoming calls from members, providers, facilities, employer groups, and other departments. Provides superior customer service that is consistent with policies, company values and quality standards.
  • Educates callers on correct use of their plans, including coverage of benefits, utilization, and administrative guidelines, in collaboration with teammates and other departments. Makes exception/empowerment decisions within the established exception policy.
  • Consistently demonstrates excellent customer service skills including problem solving, telephone etiquette, and responsiveness to customers.
  • Ensures that all department standards and expectations are met pertaining to call statistics, production, documentation, and quality/accuracy.
  • Efficiently and quickly addresses and solves problems on phone calls.
  • Meet s or exceeds department standards for call time and answered call percentage in relation to the team average.
  • Efficiently and accurately enters overrides for pharmacy claims. Meets or exceeds department standards for override audits.
  • Meets or exceeds aux code standards for the department.
  • When assigned, assists in the payment of claims for both members and pharmacies while maintaining accuracy standards.
  • Completes and analyzes specialized reports that are used to ensure timely and accurate claims adjudication.
  • Works closely with the operation and pharmacy teams to educate the staff and resolve problems.
  • Maintains the confidentiality of member's personal information to be compliant with internal confidentiality policy.
  • Maintains customer history in member tracking using correct codes and detailed comments.

Please Note

All positions subject to close without notice. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

Additional Details:

Working Hours 40

Primary Work Location SelectHealth

Expertise Clerical / Secretarial / Business Office Support, Pharmacy

Job Type Full Time

Location US-UT-Murray, US-UT-Salt Lake City