"Pharmacy Call Center Representative I"

Job Description

Come join the staff at OU HSC and become a part of Oklahoma's premier research university which leads the state in education and career opportunities. OU HSC is one of only four comprehensive academic health centers in the nation with seven professional colleges.

This position will be instrumental in our management of the pharmacy call center for the state Medicaid population, as well as being responsible for answering calls from Medicaid members and providers with a goal of achieving one call resolution. The Pharmacy Call Center Rep I provides support to patients, providers, and Pharmacy Staff by maintaining information, participating in surveys, resolving problems, cross training, and attending meetings.

Duties:

• Provides support to patients and providers.
• Responds to oral and written inquiries from the user community regarding Medicaid issues and related problems.
• Answers inquiries to include but not limited to Federal rules and regulations, Medicaid, managed care, and fee-for-service.
• Answers provider questions regarding medical claims.
• Provides support to the Pharmacy staff.
• Answers telephone calls, determines nature of call, and directs caller.
• May perform clerical duties.
• Maintains information about providers.
• Stays abreast of constantly changing Medicaid fee-for-service and managed care rule revisions in order to provide accurate information.
• Organizes reference materials for easy access.
• Updates provider information.
• Participates in patient related surveys.
• Contacts Medicaid recipients for the completion of such surveys.
• Resolves problems according to agency rules and procedures.
• Provides guidance to Medicaid providers by identifying and correcting billing problems through the explanation of procedures and benefits.
• Cross trains with Pharmacy Support Staff and management to achieve competency in all areas of pharmacy support.
• Attends staff meetings and other meetings as needed.
• Performs various duties as needed to successfully fulfill the function of the position.

Job Requirements

Required Education: High School Diploma or GED

Skills:

• Knowledge of Federal rules and regulations related to Medicaid, managed care, and fee-for-service
• Ability to solve problems
• Ability to train other Representatives
• Customer service

Working Conditions:

Physical:

• Sitting for prolonged periods.
• Speaking and listening.
• Constant use of the telephone.

Environmental:

• Standard Office Environment.