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Senior Associate, RX Specialist
full-time•Wilmington
About this role
Ametros is changing the way individuals navigate healthcare by providing them with the tools and support necessary to make educated decisions on how to spend their medical funds. Ametros's team works closely with patients, insurers, employers, attorneys, brokers, medical providers, and Medicare to create a seamless experience for our clients. Our flagship product is revolutionizing the way funds from insurance claim settlements are administered after settlement. Ametros continues to innovate, bringing new solutions to the market with the goal of simplifying healthcare for our clients. We make managing medical funds safe, effortless, and cost effective for everyone.
The Rx Specialist is primarily responsible for providing customer service on all pharmacy related services.The Rx Specialist is primarily responsible for providing customer service on all pharmacy related services.
What you will do
- Responsible for answering inbound calls and assisting members with pharmacy related services.
- Contacting members to obtain any required pharmacy related information.
- Monitor and resolve all pharmacy rejected claims within the established turnaround times and in compliance with Medicare and regulatory requirements.
- Follow-up on authorization requests in a timely fashion.
- Contact members to obtain necessary approval on rejected pharmacy claims.
- Contact PBM as needed to resolve any complex pharmacy issues.
- Document all communication, upload appropriate documents to internal database, and document clear concise notes in our database to ensure accounts are up to date.
- Proactively identify issues, and work toward resolution.
- Act in compliance with security and HIPAA policies and procedures.
Skills and Abilities
- Weekend availability required for occasional (1-2 per month) Saturday/Sunday coverage rotation.
- Proficient with prescription terminology and authorization practices.
- Knowledge of healthcare information systems, Rx products and pharmacy services.
- Previous experience in pharmacy retail, medical, or customer service setting.
- Previous experience as a Pharmacy technician.
- Telephone etiquette.
- Excellent customer service skills.
- Strong analytical and problem-solving skills.
- Thorough understanding and proficient use of customer service best practices and techniques in the Pharmacy Benefit industry.
- Working knowledge of healthcare information systems and knowledge of Rx products and pharmacy services.
- Strong conflict management and customer service skills.
- Strong interpersonal and communication skills.
- Client management and relationship building.
- Ability to foster a positive and productive work environment.
- Ability to work in a dynamic fast paced atmosphere.
Education Qualifications
- H.S. Diploma or General Education Degree (GED) required
Experience Qualifications
- 3-4 years experience in a pharmacy setting, ideally a call center pharmacy setting required
- Experience with prescription terminology and authorization practices required
- Experience with computer systems required, including some Microsoft application which may include Outlook, Work, Excel, PowerPoint or Access required
Licenses and Certifications
- National Certification from an accredited pharmacy technician certification program preferred
Webster Financial Corporation and its subsidiaries (“Webster”) are equal opportunity employers that are committed to sustaining an inclusive environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, marital status, national origin, ancestry, citizenship, sex, sexual orientation, gender identity and/or expression, physical or mental disability, protected veteran status, or any other characteristic protected by law.
What you'll do
- The Rx Specialist is responsible for providing customer service on all pharmacy-related services, including answering inbound calls and assisting members. They also monitor and resolve pharmacy rejected claims and ensure compliance with Medicare and regulatory requirements.
About Ametros
Ametros, the industry leader in professional administration, transforms how injured individuals manage their healthcare after a settlement. We empower people with the tools, support, and guidance they need to make smart, confident decisions about their medical funds.
CareGuard, our professional administration service, simplifies the administration of Medicare Set Asides (MSAs) and other future medical allocations, facilitating compliance and peace of mind. We work closely with patients, insurers, employers, attorneys, brokers, medical providers, and Medicare to deliver a seamless, supportive experience.
As a division of Webster Bank, N.A. (NYSE: WBS), a leading commercial bank headquartered in Stamford, CT, Ametros continues to innovate, bringing forward-thinking solutions to the market that make managing medical funds safe, effortless, and cost-effective.
Ametros is an equal opportunity employer that is committed to sustaining an inclusive environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, marital status, national origin, ancestry, citizenship, sex, sexual orientation, gender identity and/or expression, physical or mental disability, protected veteran status, or any other characteristic protected by law.
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Frequently Asked Questions
What does a Senior Associate, RX Specialist do at Ametros?
As a Senior Associate, RX Specialist at Ametros, you will: the Rx Specialist is responsible for providing customer service on all pharmacy-related services, including answering inbound calls and assisting members. They also monitor and resolve pharmacy rejected claims and ensure compliance with Medicare and regulatory requirements..
Is the Senior Associate, RX Specialist position at Ametros remote?
The Senior Associate, RX Specialist position at Ametros is based in Wilmington, Massachusetts, United States. Contact the company through Clera for specific work arrangement details.
How do I apply for the Senior Associate, RX Specialist position at Ametros?
You can apply for the Senior Associate, RX Specialist position at Ametrosdirectly through Clera. Click the "Apply Now" button above to start your application. Clera's AI-powered platform will help match your profile with this opportunity and guide you through the application process.