National Accounts Call Center Specialist FT- 1200355BR
Professional Diversity Network
Spartanburg, SC, USA
Job Description Job Summary: The Call Center Specialist - National Accounts is primarily responsible for reviewing pricing sheets in order to figure out medication costs. You will provide quality service through collaboration, respectful communication, maintenance of a professional environment, partnership with those we serve, and anticipation of customer needs. CIC support staff are also responsible for assisting in the resolution of rejected clinical claims management.
Primary Responsbilities: * Resolve customer issues to minimizes at risk accounts, create action plans and follow up. * Determine costs of medications through Omnicare proprietary software using facility price sheets * Input information received by the customer into the Omniview system and relay the information back to the customer regarding perspective admissions within 1 hour after receiving the information * Maintain adequate supplies needed to keep systems running effectively at customer facilities. * Responsible for all destruction of all patient specific information following HIPAA regulations * Serve as the liaison between the pharmacy and long-term care facility to identify cost saving opportunities
Secondary Responsibilities: * Initiates Prior Authorization and obtain pertinent information from facility/prescribers as directed by a CIC pharmacist or Clinical Specialist. * Call insurance plans to follow-up on submitted prior authorizations in timely manner * Communicate with CIC staff regarding the outcomes of the prior authorization requests and in the case of prior authorization denials work with pertinent staff to take the appropriate next steps in the resolution of the rejection * Communicate any changes in prior authorization criteria or issues related with various insurance plans and processors to management team. * Cross train for coverage of other positions in the CIC * Follow all applicable government regulations including HIPAA. * Display behavior which exemplifies employee code of conduct guidelines * Other duties as assigned; Job duties may vary by location
It is a 5 week rotation. One out of every 5 weeks will be 11:30A-8P. the other 4 weeks are 9A-5:30P.
Required Qualifications * Healthcare experience * Must possess excellent communication and interpersonal skills. * Must be flexible with regards to work schedule.
Preferred Qualifications * Long term care or other medical environment, but not required * State and/or Nationally Certified Pharmacy Technician preferred
Education High School Diploma or Equivalent
Business Overview It's a new day in health care.
Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation's premier health innovation company. Through our health services, insurance plans and community pharmacists, we're pioneering a bold new approach to total health. As a CVS Health colleague, you'll be at the center of it all.
We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.
CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran - we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team. Please note that we only accept applications for employment via this site.
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