Arbiter/Failed Claims Technician at WellDyne
Worldwide
<div> <div>At our company, we move fast, adapt quickly, and turn challenges into opportunities—all while keeping quality at the heart of everything we do. We believe that work should be a positive and respectful place, and that with the right mindset, anything is achievable. </div> <div><b>Our Vision:  </b></div> <div>Fulfill the essential promise of pharmacy care and help people to live to their healthiest, happiest, and fullest potential. </div> <div><b>Our Mission:  </b></div> <div>To be the disruptive force that drives meaningful change within pharmacy services. </div> </div> <div> </div> <div><b>Summary</b><br> Under the direct supervision of the Pharmacy Supervisor (FL), update prescription orders following all pharmacy procedures and guidelines.<br> <br> <b>Essential Duties and Responsibilities</b></div> <ul> <li>Perform routine, professional pharmacy functions.</li> <li>Respect and maintain confidentiality guidelines of HIPAA.</li> <li>Follow and aid in enforcement of all company policies and procedures.</li> <li>Answer all emails in the arbiter email box in a timely and accurate manner.</li> <li>Responsible for orders in failed claims and high co-pay queue.</li> <li>Ensure insurance information is accurate for correct adjudication.</li> <li>Accountable for checking patient history for refill too soon, increase/decrease of dose, and duplicate scripts.</li> <li>Ensure all prior authorizations are started in a timely and accurate manner.</li> <li>Responsible for other duties as assigned.</li> </ul> <div><b>Education and Experience</b></div> <ul> <li>High School Diploma or equivalent</li> <li>Registered Pharmacy Technician with the State of Florida.</li> <li>Preferred – national certification (CPhT)</li> <li>One year minimum of pharmacy experience</li> <li>Knowledge of health insurance plans</li> <li>Familiarity with Microsoft Word, Excel, and Outlook</li> </ul> <div><b>Knowledge, Skills, and Abilities</b></div> <ul> <li>Attention to detail.</li> <li>Ability to handle multiple activities or interruptions at once.</li> <li>Ability to communicate effectively, patiently and courteously.</li> <li>Focused team player, who can work in conjunction with pharmacists, other departments, customers, and management.</li> <li>Work independently with little supervision and meet daily deadlines.</li> <li>Ability to perform repetitious work accurately.</li> </ul> <div><br> <b>Work Environment / Physical Demands</b><br> This position is in a typical office environment which requires prolonged sitting and standing in front of a computer.<br> In addition, this position requires hand-eye coordination and manual dexterity sufficient to operate standard office equipment, including the operation of standard computer and phone equipment.<br> May have occasional high stress when dealing with customers/clients and employees.<br> This position may be required to work long hours</div><br>
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