Medicare Advantage Benefits Technician
Job Posting for Medicare Advantage Benefits Technician at Kelsey-Seybold
Overview:
Kelsey-Seybold Clinic, a Houston tradition in patient-centered care, is a multispecialty clinic with over 25 locations and comprises more than 500 physicians providing primary and specialty care in a collaborative manner.
With 55 different clinical and non-clinical specialties, you can design a career path at Kelsey-Seybold Clinic that allows you to grow your future in a completely new direction.
Kelsey-Seybold Clinic is changing the way health cares.
Responsibilities:
EDUCATION REQUIREMENTS & EXPERIENCE REQUIREMENTS
Education
A.
High School diploma or GED from an accredited program
B.
Some college or technical school
Experience
A.
6 months operational pharmacy benefit experience
OR
6 months experience in a high volume call center
OR
6 months of customer service experience
OR
6 months retail pharmacy experience
B.
2 years Medicare Part D experience
2 years high volume call center experience
Licenses
A.
TSBP Registered Pharmacy Technician
B.
2 years HMO 3rd party managed care experience
Special Skills
A.
Good Alpha/Numeric data entry skills with minimal errors
Excellent customer service, telephone etiquette skills, and active listening skills
Proficient 2 with computer applications that including, but not limited to: Microsoft Word, Excel, and Access
Demonstrates strong problem solving and analytical skills
Type 20 WPM. 10 key by touch
Auditing experience
Ability to exercise good judgment during high call volume while maintaining a professional attitude
Other
A.
Communication skills, professional appearance, and ability to work effectively in a fast paced work environment.
Ability to speak, write and understand the English language
Detail oriented with excellent verbal and written communication skills
B.
Bilingual English/Spanish
WORKING ENVIRONMENT
Kelsey-Seybold Clinic, a Houston tradition in patient-centered care, is a multispecialty clinic with over 25 locations and comprises more than 500 physicians providing primary and specialty care in a collaborative manner.
With 55 different clinical and non-clinical specialties, you can design a career path at Kelsey-Seybold Clinic that allows you to grow your future in a completely new direction.
Kelsey-Seybold Clinic is changing the way health cares.
This position is responsible for assisting the Pharmacy Health Plan Services area in the management of the Medicare Advantage Part D prescription benefits. Under the supervision of the Health Plan Pharmacy Manager and/or Supervisor, this position is primarily responsible for triaging and/or resolving pharmacy services phone calls, audits and monitoring functions that help ensure prescription benefits are administered cost effectively, timely, accurately and in compliance with CMS standards. This position also includes, processing coverage determinations per Medicare Part D program regulations and assisting the Health Plan Pharmacy Services department with the management of Kelsey-Seybold Clinics’ Pharmacy Quality Initiatives (i.e. MTMP, Hospital Discharge, RXQI, and Adherence). Additional activities may include scheduling appointments and monitoring functions that help ensure Pharmacy Initiatives are administered efficiently, accurately and in compliance with the departments’ standard operating procedures. This position may conduct outbound calls regarding patient adherence to medications and assist patients to refill medications in a prompt and courteous manner utilizing a PC. This position is also responsible for general clerical duties which include but are not limited to member mailings, verifying addresses for return mail, data entry, processing collection letters and documenting member outcomes. This position confirms appointments and handles cancellations in a timely, efficient and courteous manner. The employee in this position should be able to provide comprehensive service in order to facilitate a resolution to caller requests and triage calls to the appropriate team members when necessary. The employee should acquire and maintain computer skills to effectively utilize software and Windows based programs as well as be able to quickly learn processes and put into practice learned principles.
Qualifications:
Medicare Advantage Benefits Tech
Location: Pearland Administrative Office
Department: KS Advantage
Job Type: Full Time
Job Type: Full Time
Salary Range: $41,300.80 to $54,207.30 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)
EDUCATION REQUIREMENTS & EXPERIENCE REQUIREMENTS
(A = basics; B = preferred)
Education
A.
High School diploma or GED from an accredited program
B.
Some college or technical school
Experience
A.
6 months operational pharmacy benefit experience
OR
6 months experience in a high volume call center
OR
6 months of customer service experience
OR
6 months retail pharmacy experience
B.
2 years Medicare Part D experience
2 years high volume call center experience
Licenses
A.
TSBP Registered Pharmacy Technician
B.
2 years HMO 3rd party managed care experience
Special Skills
A.
Good Alpha/Numeric data entry skills with minimal errors
Excellent customer service, telephone etiquette skills, and active listening skills
Proficient 2 with computer applications that including, but not limited to: Microsoft Word, Excel, and Access
Demonstrates strong problem solving and analytical skills
Type 20 WPM. 10 key by touch
B.
Auditing experience
Ability to exercise good judgment during high call volume while maintaining a professional attitude
Other
A.
Communication skills, professional appearance, and ability to work effectively in a fast paced work environment.
Ability to speak, write and understand the English language
Detail oriented with excellent verbal and written communication skills
B.
Bilingual English/Spanish
WORKING ENVIRONMENT
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Salary.com Estimation for Medicare Advantage Benefits Technician in Pearland, TX
$41,065 to $53,084
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