Works under the direction of the Sr. Rep.(Team Lead) and Operations Manager to coordinate the needs of patients taking complex medications related to their medical condition, disease or illness. Works proactively with our patients, provider offices and clients via the telephone and directly on site to compassionately and efficiently coordinate medication shipments, medication adherence services, provider support, and overall customer service for specialty medications. In addition, the Rep I Pharmacy Specialty Mail has a thorough knowledge of specialty operations to ensure that our patients are maximizing the integrated pharmacy services provided by Apothecary by Design.
• Have ability to exercise judgment under pressure and use analytical ability to affect solutions required
• Ensure that customers have a positive experience; commits to meet or exceed customer expectations
• Have effective communication, people and organizational skills (verbal and written)
• Will possess the ability to build relationships with our provider partners by working with them to successfully fulfill and exceed the needs of their patients who are prescribed a specialty medication.
• Be flexible to help with other ABD jobs as needed
• Will have in-depth knowledge of insurance coverage, terminology and benefit investigation Able to do test claims and identify insurance coverage and benefit coordination. Performs any required prior authorization. Able to communicate coverage details to patients and providers. Researches co-pay assistance and financial assistance programs as appropriate.
• Will have basic knowledge of medical terminology, as well as a baseline understanding of specialty medications. Able to troubleshoot medication regimen issues, ex. Knowledge of regimen sequence to prioritize which items patients will need in what order, and to coordinate shipments accordingly.
• Ability to compassionately ensure that each patient feels they have received the utmost in personalized care for their disease condition.
• Able to work in a fast-paced environment handling urgent patient needs. Capability to multitask is essential without sacrificing quality and attention to detail.
• Be available to work from 8am-6:30pm, Monday – Friday
Prior experience in a healthcare setting
• Proficient PC and computer skills
• 2 yr Medical Assistant degree or pharmacy experience is desirable
• Pharmacy Technician experience highly desirable
• Experience working at an insurance company in plan design, benefit investigation, or at a pharmacy is desirable
• Prior experience in specialty office setting preferred
High school diploma
It's a new day in health care.
Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation's premier health innovation company. Through our health services, insurance plans and community pharmacists, we're pioneering a bold new approach to total health. As a CVS Health colleague, you'll be at the center of it all.
We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.
CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran – we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team. Please note that we only accept applications for employment via this site.
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