FSLA STATUS: Exempt
REPORTS TO: Operations Manager, Rx Linc Network Services
Position provides support for Nationwide Pharmacy Claims Network, Pre/Post Edit (PPE), and ePrescribe network services for pharmacy customers and vendors. Reviews and analyzes claims transmissions and responses for adjudication issues. Position applies support knowledge to: (1) support day-to-day network services providing excellent customer support, (2) Demonstrates how Programs are cost effective and, (3) identifies data anomalies/gaps working to resolution.
Duties and Responsibilities
Position is responsible for the following duties and responsibilities:
- Collecting, analyzing, interpreting, and summarizing claims data as required for Network services.
- Assisting customers to resolve support issues related to the Company’s PPE and other Company provided services.
- Collect and review weekly claims analysis for customer follow up.
- Ensure weekly customer reports are accurate and pushed-out in a timely manner.
- Daily support of Rx Linc’s ePrescribe service working with vendors and customers alike.
- Summarizes and generates weekly claim reports to be provided to /Management for review.
- Generates and reviews for accuracy monthly summary reports to be provided to Management for review.
- Effectively communicating on a daily basis with Pharmacy staff generating rapport and a positive customer experience.
- Working with new pharmacies in obtaining vendor specific documents/agreements for enrollment in RxLinc Services.
- Work with vendor partners to establish RxLinc services for new pharmacies and/or pharmacy groups.
- Ability to promote to Rx Linc Clients the benefits and value of company products & services.
- Successfully complete pharmacy outreach projects as assigned.
- Adequately document pertinent Customer conversations in Company database.
- Establish and maintain an effective follow-up system to ensure problems are promptly solved.
- Actively participate in team meetings and effectively work in a team environment.
- Continually demonstrate a competence to accurately complete assigned routine daily, weekly, monthly, quarterly or assigned recurring responsibilities.
- Apply knowledge and/or quality analysis to prepare reports.
- Provide input /recommendations on procedures.
- Any other work as may be assigned by the Company.
- Bachelor’s degree in business related field or two to three years of related pharmacy industry experience
- Possess and demonstrate the ability to effectively follow oral/written instructions, analyze data, apply good fact-finding skills to solve relevant and related pharmacy problems associated with services provided to subscribers, and to identify customer informational needs and their appropriate solutions.
- Above average proficiency in pc applications which include: Microsoft windows, Internet, word
processing (Word), spreadsheets (Excel), presentation software (Powerpoint), email (Outlook) and file
management skills. Able to learn company-specific applications
- Strong Communication skills
- Ability to accurately multitask and work in a fast-paced environment.
- Self-motivated and results driven
- Possess and apply good error checking skills.
- Possess and effectively apply good diction to above average Customer service and Communication skills.
- Checks programs to ensure the programs produce the desired results and that identified errors have been corrected.
- Ability to work with minimal supervision, in a team environment, and to be able to prioritize projects and devote time on projects according to priority.
- Maintain good relationships with teammates and customers alike.
- Salary to commensurate with experience and skillset. Healthcare Benefits and Employer matched retirement up to 3%. PTO accrued monthly. Annual performance reviews provided.
Physical Requirements / Work Environment
This work is sedentary and requires the following physical activities:
- Sitting for long periods of time; occasional bending, squatting, kneeling, stooping; good finger dexterity and feeling; frequent repetitive motions; talking, hearing, and visual acuity.
- Frequent lifting (up to 10 pounds of paper supplies or minor office equipment).
- Normal office environment.
NOTE: The above statements are intended to describe the general nature and level of work performed by an employee in this position. These statements are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of employees in this position.