Clinical Service Center Technician

Overview

The Clinical Service Center Technician is responsible for assisting the CSC Pharmacist with the day-to-day operational needs, including adjudication of clinical claims, processing prior authorization forms and meeting the requirements of the Clinical Service Center. Adheres to the company’s quality and customer service standards, policies and procedures, and state and federal guidelines.

Responsbilities

• Obtains formulary alternative information and provides to CSC pharmacist.
• Selects appropriate prior authorization forms, completes them as directed by the CSC pharmacist and submits to the applicable payer for review in a timely manner.
• Documents all actions taken to resolve a clinical rejection in the respective pharmacy operating systems
• Communicates with customers, insurance companies and internal pharmacy staff to effectively and appropriately resolve rejected clinical claims
• Maintains organized record of CSC documentation related to claims management
• Applies superior customer service skills when working with both internal and external customers
• Works in collaboration with the CSC Pharmacists and Director to meet department goals and objectives.
• Actively contributes to the evaluation and continuous improvement of client services, policies and procedures.

Qualifications

• High School graduate or equivalent required.
• Current National/State Pharmacy Certification preferred but NOT REQUIRED
• Basic computer knowledge skills required
• Basic understanding of medical terminology, medical billing practices, math and analytical skills is preferred, but not required.
• Patient accounts and/or billing experience is preferred.

WHY REMEDI?

Remedi SeniorCare is one of the nation’s TOP TEN long term care pharmacies. We offer nursing homes and assisted-living facilities everything they need to provide better care to their residents by delivering highly responsive pharmacy solutions.

Remedi SeniorCare is currently looking for enthusiastic, motivated and talented individuals to join its Pharmacy Operations team. Our Pharmacy delivers life-saving medications to thousands of residents every day across Ohio. Our team members enjoy climate-controlled state-of-the-art facility equipped with customer-inspired innovative technologies.

Remedi offers great benefits and perks that include health, vision, and dental insurance, flexible spending and health savings account, life insurance/long- and short-term disability, and a 401K match!