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Pharmacy Benefits Specialist

genfinity · 30+ days ago
Negotiable
Full-time
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CADENCE RX 

Not just another PBM 

Founded in early 2019, Cadence Rx launched an industry-leading peer-to-peer prescription platform created to elevate our clients’ experience within the workers’ compensation market. These goals are achieved through agile responsiveness, advanced technology, and true transparency. Cadence Rx, Inc. is a privately held business based in Tampa, Florida. We are a nationally recognized woman-owned business exclusively serving the national workers’ compensation market. Cadence Rx is an agile and entrepreneurial enterprise led by a dedicated team of industry professionals who share extensive workers’ compensation knowledge, pharmacy expertise, and experience in offering a high-touch customer service model. 

Position Summary: 

A Pharmacy Benefits Specialist assists with resolving business related cases by taking the necessary workflow steps. Responsibilities include making outreaches to the pharmacy to complete tasks such as, provide billing information, process pending medications, and update pharmacy information.  

Roles and Responsibilities: 

  • Work in designated queues to complete business-related tasks. 

  • Handle call back cases to coordinate with pharmacy to process pending approved medications. 

  • Identify and prioritize cases that need immediate action and / or escalation. 

  • Assist pharmacies with updating payers’ billing information. 

  • Document and update records in Microsoft Dynamics 365. 

  • Consistently meet required metrics while maintaining quality standards. 

  • Adhere to all company policies and procedures, and local, state and federal laws and regulations. 

  • Other duties as assigned. 

Qualifications: 

  • College graduate of any 4-year course, allied health course is an advantage. 

  • Minimum 2 years of customer service experience in any field required. 

  • Experience in US Healthcare and Workers’ Compensation is an advantage. 

  • Prior knowledge of US pharmacy procedures, medical terminology, and the use of common medications preferred.  

  • Knowledge of HIPAA principles and standards is an advantage. 

  • Proficiency in Microsoft suite of products specifically Word, Excel and Outlook preferred. 

  • Exposure to Microsoft Dynamics 365 is an advantage. 

  • Must have excellent organizational, communication and customer service skills. 

  • Keen attention to detail. 

  • Excellent follow-through abilities and ability to coordinate several items simultaneously. 

  • Exercise considerable discretion, maintain confidentiality and practice independent judgment. 

  • Work as a team player in conjunction with all areas of the organization. 

  • Practice professional phone etiquette.  

  • Demonstrates initiative to proactively solve issues with minimal supervision. 

  • Typing speed of > 45 words per minute preferred. 

  • Willing to work any assigned shift during a work week in Makati City

  • Onsite training then Hybrid set up afterwards 

  • Earn up to 45,000 depending on the experience and performance during interviews. 

All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, ethnicity, age, disability, marital status, or any other characteristic protected by law.

Genfinity as an Equal Opportunity Employer, believes in each person’s potential, and we’ll help you achieve yours.

All information will be kept confidential according to EEO guidelines.

Last updated on Nov 20, 2024

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