**Overview** **Scope of Responsibilities:** Works under general supervision. Follows standard procedures to accomplish assigned tasks. May assist in orienting and training employees **Job Summary:** Responsible for all aspects related to adjudication and billing of specialty prescriptions in a call center environment. **Responsibilities** **Job Duties:** + Responsible for monitoring adjudication queue(s) + Responsible for contacting members and prescribers on non-covered items + Facilitate prior authorization process for customers + Provide clinical services in TherigySTM + Customer service coverage for incoming calls and directing incoming calls + Provides resolution to customer service issues to ensure member satisfaction + Work with members to provide resolution to payment related issues on accounts/orders + Maintain and keep reasonable production as determined by supervisor + May assist in orienting and training new employees + Responsible for completing all mandatory and regulatory training programs + Perform other duties as assigned **Qualifications** **Attendance Requirements:** + Must be available, and on-time for scheduled work shifts. + Must be able to work nights and weekends as required. **Educational Requirements:** + Minimum: High School Diploma or GED + Preferred: Pharmacy technician or related certification **Experience:** + Past experience in a customer service related field + 6-12 months experience as a pharmacy technician **Special Conditions of Employment:** + Drug test + Initial and continuous exclusion and sanction/disciplinary monitoring + Any and all additional eligibility requirements based on the specific position **Job Skill Requirements:** + Broad knowledge of medications, physician orders, and pharmacy systems + Familiar with Enterprise billing options and practices surrounding claim submission + Strong communication skills + Outstanding customer service skills + Excellent organization skills + Ability to multitask and prioritize + Excellent computer and keyboarding skills + Successful completion of a pre-employment and/or random drug screening test **Required Training:** + HIPPA Privacy Course + HIPPA Security Course + Fraud, Waste, and Abuse Course + MethGuard Course + HIPPA Privacy CE Mastery Exam + HIPPA Security CE Mastery Exam + Fraud, Waste, and Abuse CE Mastery Exam + MethGuard CE Mastery Exam **Behavioral Traits Required:** + Cooperation: Must work harmoniously and effectively with fellow employees, supervisors and others you are in contact with + Initiative: Must work within supervision guidelines and assume additional responsibilities + Flexibility: Must be willing to work variable work schedules, nights and weekends, assist others as requested and available, and be willing to perform all assigned work + Adaptability: Must respond to new situations in a positive way, accept change, support new ideas, master new routines and grasp explanations, apply current knowledge in new environments and experiences + Involvement: Must enjoy the demands of the job and work with interest and enthusiasm + Customer Service: Must provide superior customer service (for Noble customers, fellow employees and business partners), listen attentively to their needs and respond appropriately + Safety: Must take care of equipment and employ good safety habits + Leadership: Must gain acceptance of ideas and accomplish goals through subordinates, peers and teams **Compensation** **$17.50-19.37 an hour** **The final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience and education.** **KPH Healthcare Services, Inc. is a multistate organization and abides by all local, state and federal regulations as it pertains to minimum wage requirements** **.** Connect With Us! (https://kphcareers-kphhealthcareservices.icims.com/jobs/11219/patient-benefit-specialist-specialty-pharmacy-technician/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336031866) **Job Locations** _US-MS-Flowood_ **Posted Date** _1 year ago_ _(10/25/2023 3:49 PM)_ **_Requisition ID_** _2023-11219_ **_\# of Openings_** _3_ **_Category_** _Customer Service/Support_ **_Location : Location_** _US-MS-Flowood_ **_Min_** _USD $17.50/Hr._ **_Max_** _USD $19.37/Hr._