Pharmacy Customer Service Representative

Pharmacy Customer Service Representative

The Pharmacy Customer Service Representative serves as the initial point of contact for inquiries related to Utah Medicaid Pharmacy Services, including claims adjudication, prior authorization details, and pharmacy-related policy questions. This role also provides administrative support to the clinical team through data entry and other tasks associated with the pharmacy prior authorization process.

Responsibilities:

• Deliver accurate and professional assistance to members, providers, and internal teams
• Document all interactions and outcomes within the appropriate internal systems
• Assist the clinical team with administrative tasks including data entry for prior authorization reviews
• Adhere to HIPAA regulations and organizational policies at all times
• Handle incoming phone calls related to pharmacy claims adjudication issues, prior authorization requirements, status updates, and general inquiries
• Pharmacy policy interpretation and clarification

Qualifications:

• Minimum of one year of customer service experience, preferably in a healthcare, pharmacy or insurance environment
• Strong communication skills and the ability to manage complex inquiries efficiently
• Proficiency in using computer systems and working in a fast-paced, detail-driven environment
• Applicants with experience in pharmacy claims processing and related operations may be given preference

Work Schedule:

• Full-time, 40 hours per week
• Shifts scheduled Monday through Friday between 8:00 am and 6:00 pm
• Note: as of April 8, 2024, DHHS employees will be working a hybrid schedule, which includes 2 office days per week and 3 telework days.

Why work for the Utah Department of Health and Human Services? In addition to the rich benefits the State of Utah offers, the department offers:

• On-site fitness center, for a minimal membership fee
• UTA Eco Pass, at a discounted monthly rate
• Teleworking opportunities with a minimum 2 office days per week beginning 04/2024
• On-site day care center at the Cannon Health Building with First Steps Day Care - contact for rates and availability, 385-382-4012

If offered this position, your employment will be contingent upon passing a background check and review. There will be no cost to you for this check. This check will include fingerprinting, which will be available at various DHHS locations for your convenience. Fingerprinting will be completed prior to your first day of employment.