Job Title: Pharmacy Service Representative Associate
Location: Danville, PA
Department: Geisinger Health Plan
Work Type: Full Time
Assists Pharmacy Customer Service leadership in processing provider, and member prior authorization requests. Works with the pharmacy team in implementing policies to manage pharmacy benefits of the Geisinger Health Plan.
Responsible for attaining the highest level of customer satisfaction while providing feedback on the progress of defined goals essential to success of the Geisinger Health Plan.
Proficient in handling pharmacy prior authorization requests for GHP Family, but not limited to all other lines of business including Commercial and Gold business.
Must be able to maintain member/provider confidence by helping to protect the confidentiality of information coming into and being disseminated out of the department in accordance to HIPAA guidelines.
Reports directly to the Team Leader, Pharmacy Customer Service Operations and works in cooperation with the Geisinger Health Plan staff
Competencies and Skills:
Demonstrates excellent communication skills to include oral, written, audio and electronic communication skills, with a willingness to learn and function in a team environment.
Demonstrates excellent organization and time management skills and ability to work independently. Demonstrates keyboarding proficiency.
Demonstrates knowledge of medical terminology pertaining to pharmaceuticals and operational knowledge of benefit plans.
Demonstrates thorough knowledge of products and processes to respond to prior authorization requests from members and physicians.
Demonstrates experience with the following software programs/systems preferred: CSI, MedAccess, Epic, Outlook, and Microsoft Office products.
The specific statements shown above are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.
Education / Experience:
High school degree or equivalent required.
Minimum two years experience in a customer service role required, preferably in a hospital, clinic, or insurance environment.
Working Conditions/Physical Demands:
Work is typically performed in an office environment
OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
Geisinger Health Plan (GHP) is the health insurance component of Geisinger and serves over 460,000 members in Pennsylvania. Begun in 1985, GHP provides high quality, affordable health-care benefits for businesses of all sizes, individuals and families, and Medicare beneficiaries.
About Geisinger: Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13 hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers.
Internal Number: 65692
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh Food
Farmacy, a program that delivers life-saving healthy alternatives to patients with diabetes. With additional tools like our MyCode Community Health Initiative, one of the first health system genome sequencing
programs, and our new asthma app suite that we developed in partnership with AstraZeneca, it’s no wonder we’re ranked one of the Top 5 Most Innovative Healthcare Systems by Becker's Hospital Review. We continually work towards continuous improvement in a culture where everyone has a voice and firmly believe that better begins with all of us.
Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13 hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers.
What you do at Geisinger shapes the future of health and improves lives – for our patients, communities, and you.
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