JOB REQUIREMENTS: Pharmacy Benefits Reinvented- As the industry\'salternative pharmacy benefit manager (PBM), we\'re committed to makingprescriptions more affordable for you and your members. Here at Navitus,our team members work in an environment that celebrates creativity,fosters diversity and encourages growth. We welcome new ideas and sharea passion for excellence. The Customer Care Specialist (CCS) willanswer, research, and troubleshoot incoming Customer Care calls frommembers, providers, and pharmacies. The Customer Care Specialist (CCS)will provide coverage for determinations, manual claims, and/orrecoveries or other duties or projects as assigned. The CCS will giveaccurate and timely responses to inquiries. The CCS will work with otherteam members to meet the departmental performance metrics and the CCS\'smain priority will always be answering any calls that are waiting. TheCCS will document all calls handled in a complete, clear, and concisemanner. Is this you? Find out more below! How do I make an impact on myteam? Research and analyze electronic and manual claims. Applytroubleshooting skills to resolve issues as allowed by the individualbenefit Communicate prior authorization, exception, and appealsinformation to callers including required information,turn-around-times, and other applicable details Act as a pharmacy helpdesk specialist to aid pharmacies in submitting claims to includeparticipation status, accurate processing codes, reject resolution/assistance, formulary product information, and clinical programinformation Inform members how to use their benefit includinginformation regarding participating pharmacies, best utilization oftheir benefit, formulary explanations, patient pay amounts, benefitrestrictions, and other information as applicable Educate customers sothey can better assist themselves to include available website/ portalfunctions. This includes anticipating and addressing questions which maydrive repeat calls What our team expects from you? A high school degreeor equivalent. Post high school education desired such as L.P.N. orCertified Pharmacy Technician Previous customer service experiencerequired Previous data entry experience preferred Bilingual skills(Spanish speaking) are highly desirable Experience in a PBM or managedcare call center desired. Experience in a mail or retail pharmacysetting desired Participate in, adhere to, and support complianceprogram objectives The ability to consistently interact cooperativelyand respectfully with other employees What can you expect from Navitus?Hours/Location: Monday - Friday 24/7, Remote Paid Volunteer HoursEducational Assistance Plan and Professional Membership assistanceReferral Bonus Program - up to \$750! Top of the industry benefits forHealth, Dental, and Vision... For full info follow application link.Navitus Health Solutions is an Equal Opportunity Employer:Disabled/Veterans/Male/Female/Minority/Other ***** APPLICATIONINSTRUCTIONS: Apply Online: ipc.us/t/EDC010C1B4934547