Pharmacy Service Clerk jobs in Kalamazoo, MI

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POSITION: PHARMACY TECHNICIAN - HELP DESK TECHNICIAN Specialist (JD67)

The Helpdesk Technician Specialist is responsible for supporting pharmacies, members, brokers, third party administrators (TPA’s) and other health professionals regarding pharmacy benefit claim adjudications.

The specialist is a key point of contact to all individuals reaching out to OptiMed. They are responsible for coordinating and facilitating member care services and communications that help to enhance the member’s experience. The specialist will collaborate with the member, pharmacies, medical providers, TPA’s to ensure prescription claims process properly according to the member’s plan sponsor’s benefit design. The specialist position is very broad in terms of different professionals they will interact and support including broker’s, TPA’s,
Human Resource Representatives (HR), Pharmaceutical Manufacturers, and OptiMed’s clinical and account management teams.

Primary responsibilities are:

• Incoming call resolution from members, brokers, HR, TPA’s, etc.
• Troubleshoot claims processing issues for pharmacies.
• Assist members with understanding their pharmacy benefit plan design details: (copay’s, formulary, formulary alternatives, deductibles, etc.).
• Assist Pharmacies with rejection resolution.

Additional responsibilities include:

• Coordinate, setup, and communicate prior authorization (PA) for all stakeholders: members, pharmacies, and providers.
• Work with OptiMed Health Partners’ various teams to ensure a cohesive member experience.
• Obtaining the PBM certification through NPTA
• Direct Member Reimbursements
• MAP billing
• Importation billings
• Prior authorization processing (Ascend and Carveouts)
• Communication with Brokers/Member Groups/Members
• Special project lead when needed
• Assist Ascend account manager when needed
• Requests from PE/MAP team o unbranded PA’s
• Print ID cards for member groups weekly
• Benefit check calls from third parties
• Entering medications into the med list
• Manually add new patients to PBM system o Cobra/new members
• Assisting with patient portal questions
• Additional tasks as may be assigned by the Ascend Help Desk Supervisor.

Supervisory Responsibilities
The specialist does not hold a supervisory role. They report directly reports to the Ascend Help Desk Supervisor.

Minimum Qualifications
A minimum of 1-2 years of experience in pharmacy is preferred. Must be familiar with standard pharmacy protocol, insurance practices, and patient assistance programs. They must be able to work efficiently in a structured environment, follow directions, communicate effectively and be reliable. Attention to detail, organization and

6480 Technology Avenue, Suite A | Kalamazoo, Michigan 49009 | Phone: 877.232.2857 | Fax:
877.326.2856 | optimedhp.com

resourcefulness is key. They must have strong communication skills, problem solving abilities, and an independent self-starter attitude.

Work Environment
The specialist thrives in a faced-paced work environment. Sitting for prolonged periods of time at a desk, spending large amounts of time working on a computer and/or talking on the telephone in an office setting. Light to moderate lifting may be required at times. Must be able to spend most of the day in an open, work environment with other
HDT’s, pharmacy technicians and staff members alike. Reasonable accommodations can be made to enable individuals with disabilities to perform the essential job functions. The position is based at our Headquarters location here in Kalamazoo, MI.

V01162023D

6480 Technology Avenue, Suite A | Kalamazoo, Michigan 49009 | Phone: 877.232.2857 | Fax:
877.326.2856 | optimedhp.com

Job Type: Full-time

Pay: $19.00 - $20.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Referral program
• Vision insurance

Physical setting:

• Call center
• Office

Schedule:

• Day shift
• Evening shift
• Monday to Friday
• On call

Experience:

• Pharmacy technician experience: 1 year (Preferred)

Shift availability:

• Day Shift (Required)

Ability to Relocate:

• Kalamazoo, MI 49009: Relocate before starting work (Required)

Work Location: In person