May 30, 2020

National Accounts Call Center Specialist FT- 1269724BR

  • Professional Diversity Network
  • Spartanburg, SC, USA

Job Description

CVS Health

Job DescriptionJob 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 opportunitiesSecondary 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 locationIt 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 preferredEducationHigh School Diploma or EquivalentBusiness OverviewIt'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.At CVS Health, we work every day to help people on their path to better health. Never has it been more important for us to deliver on our purpose to our valued customers, patients, members, and employees. With a presence in communities across the country, CVS Health colleagues are and will continue to be a critical piece of the country's health care solution. The health and safety of our employees, patients, customers, and members is our top priority as we face the impact of COVID-19 together. If you would like to learn about the actions we are taking as a company as we learn more about COVID-19 and its spread, we encourage you to visit our COVID-19 resource center at 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. Please note that we only accept applications for employment via this site.We provide reasonable accommodations to qualified individuals with disabilities. If you need to request an accommodation, a qualified interpreter, written information in other formats, translation or other services, please contact our Advice and Counsel Reasonable Accommodations team by emailing Advice and Counsel Reasonable Accommodations team or calling 877-805-9511.If technical issues are preventing you from applying to a position, contact Kenexa Helpdesk at 1-855-338-5609 or For technical issues with the Virtual Job Tryout, contact the Modern Hire Help Desk at 1-877-451-1695 or

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