Pharmacy Resolution Specialist

Centene

Base: $15.87 - $27.25 ph; bonus/equity: not specif...
Hybrid
Inbound and outbound call handling
Prior authorization request submission
Pharmacy benefit knowledge
Centene is seeking a Pharmacy Resolution Specialist to enhance member relationships by resolving pharmacy benefit inquiries and ensuring compliance with regulations. The ideal candidate should have a high school diploma and at least a year of call center or customer service experience, with a focus on detail-oriented problem-solving

Job Summary

  • This role involves responding to calls from members, provider offices, and pharmacies to resolve pharmacy-related inquiries.
  • The specialist is responsible for entering pharmacy overrides, managing prior authorization requests, and ensuring compliance with CMS regulations.
  • Centene offers a comprehensive benefits package including health insurance, 401K, tuition reimbursement, and flexible work schedules.

Matching Summary

Match Score: 75

Centene is seeking a Pharmacy Resolution Specialist to enhance member relationships by resolving pharmacy benefit inquiries and ensuring compliance with regulations. The ideal candidate should have a high school diploma and at least a year of call center or customer service experience, with a focus on detail-oriented problem-solving.

Salary

Base: $15.87 - $27.25 per hour; Bonus/Equity: Not specified; Benefits: Health insurance, 401K, stock purchase plans, tuition reimbursement, paid time off

Skills & Requirements

Must-have

  • Inbound and outbound call handling
  • Prior authorization request submission
  • Pharmacy benefit knowledge
  • CMS regulation compliance
  • Claims resolution expertise

Nice-to-have

  • Root cause analysis skills
  • Enterprise solution communication
  • First call resolution focus
  • Special project assistance
  • Flexible work schedule adaptability

Key Requirements

  • High School Diploma or GED
  • 1 year of call center experience
  • Authorized to work in the U.S. without visa sponsorship

Work Rights

Must be authorized to work in the U.S.

Tailored Resume

Cover Letter