Pharmacy Care Representative

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary CVS Health/Specialty is offering an exciting opportunity to be part of our Pharmacy Care Representative team. In this customer service role, you will interact directly with customers to answer questions, solve problems, provide education, and maintain our company’s reputation for high-quality service. This includes new patient enrollment, verification of insurance coverage, performing benefit investigations and processing of medication orders for both new and existing patients. Qualified candidates will be comfortable in a multi-tasking, high-energy environment. Creative problem solvers with a passion for excellent customer service. As a Pharmacy Care Rep, you will:

• Conduct inbound or outbound phone calls to patients regarding complex Specialty medication orders, benefits verification, and new patient enrollment.
• Coordinate and process requests for new and refill order shipments. Collect appropriate information needed to ensure insurance coverage for patient medication orders
• Verify eligibility, prior authorization, and other reimbursement requirements prior to shipment.
• Assist in enrolling and tracking new customer referrals.
• Provide explanation of CVS/Specialty services to new customers
• Transfer/escalate clinical questions and issues to the staff pharmacist for resolution.

This is primarily a WORK FROM HOME position. However, candidates must live within a 75-mile commutable distance from Fairfield, NJ and be willing to come onsite for equipment/technical issues, and performance review discussions. Training allows our new team members to familiarize themselves with members of training, support, leadership, and their new peers to ensure a successful and team-focused onboarding experience. This position is full-time and offers overtime during our business peaks. We offer a comprehensive benefits package which includes medical, dental, vision insurance as well as a wide-ranging list of supplemental benefits and discount programs. In addition to sixteen paid days off for employees, we also offer ten paid holidays. Our application process is 2 simple steps:

• Apply online.
• Take your time while completing our Virtual Job Tryout (VJT)

Required Qualifications

• Must live within 75 miles of Fairfield, NJ
• 1+ years of experience in a customer service role handling and resolving a high volume of complex customer needs over the phone
• 1+ years of work experience with Windows-based applications like Microsoft Office (Outlook, Excel, Teams, Word) internet navigation, and email applications.
• 1+ years of computer keyboarding experience, skills and aptitude.
• You must have a direct/hardwired internet connection to a modem/router within 7 feet of your computer and a minimum download speed of 25 mbs download and 3 mbs upload. WiFi and satellite are not permitted. A secure and private home workspace free from distractions is required.

Preferred Qualifications

• Prior healthcare work experience and familiarity with benefits, insurance, prescriptions, medical terminology
• Previous experience working with Prior Authorizations.
• Experience with various insurance plans offered by both government and commercial insurances (i.e., PPO, HMO, EPO, POS, Medicare, Medicaid, HRA’s) and coordination of healthcare benefits, including requirements for referral, authorization, and pre-determination.
• Experience with reading, and understanding medical policy information, and utilizing insurance benefit and coverage information to calculate estimated patient responsibility, taking into consideration pre-determination, referral, authorization, and contract terms.
• Experience receiving inbound calls and making outbound calls to patients to explain insurance benefits related to health insurance, and/or discussing patient financial responsibilities.
• Knowledge with using Avaya-One X, Availity, Change HealthCare and/or CoverMyMeds.
• Pharmacy Technician license

Education

• High School Diploma or equivalent work experience.

Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $17.00 - $31.30 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Apply tot his job Apply To this Job