Assists Pharmacy Customer Service leadership in processing provider, and member prior authorization requests. Works with the pharmacy team in implementing policies to manage pharmacy benefits of the Geisinger Health Plan.
Reports directly to the Team Leader, Pharmacy Customer Service Operations and works in cooperation with the Geisinger Health Plan staff.
COMPETENCIES AND SKILLS:
Demonstrates excellent communication skills to include oral, written, audio and electronic communication skills, with a willingness to learn and function in a team environment.
Demonstrates excellent organization and time management skills and ability to work independently. Demonstrates keyboarding proficiency.
Demonstrates knowledge of medical terminology pertaining to pharmaceuticals and operational knowledge of benefit plans.
Demonstrates thorough knowledge of products and processes to respond to prior authorization requests from members and physicians.
Demonstrates experience with the following software programs/systems preferred: CSI, MedAccess, Epic, Outlook, and Microsoft Office products
The specific statements shown above are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job
EDUCATION AND/OR EXPERIENCE:
High school degree or equivalent required.
Minimum two years experience in a customer service role required, preferably in a hospital, clinic, or insurance environment
WORKING CONDITIONS/PHYSICAL DEMANDS:
Work is typically performed in an office environment
OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
GEISINGER HEALTH PLAN (GHP) is the health insurance component of Geisinger and serves over 460,000 members in Pennsylvania and West Virginia. Begun in 1985, GHP provides high quality, affordable health-care benefits for businesses of all sizes, individuals and families, and Medicare beneficiaries.
About Geisinger: Geisinger is a physician-led health system comprised of approximately 30,000 employees, including nearly 1,600 employed physicians, 13 hospital campuses, two research centers, and a 583,000-member health plan Geisinger is nationally recognized for innovative practices and quality care. Geisinger serves more than 3 million people in central, south-central and northeast Pennsylvania and also in southern New Jersey with the addition of National Malcolm Baldridge Award recipient AtlantiCare, A member of Geisinger. In 2017, the Geisinger Commonwealth School of Medicine became the newest member of the Geisinger Family.
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh Food
Farmacy, a program that delivers life-saving healthy alternatives to patients with diabetes. With additional tools like our MyCode Community Health Initiative, one of the first health system genome sequencing
programs, and our new asthma app suite that we developed in partnership with AstraZeneca, it’s no wonder we’re ranked one of the Top 5 Most Innovative Healthcare Systems by Becker's Hospital Review. We continually work towards continuous improvement in a culture where everyone has a voice and firmly believe that better begins with all of us.
Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13 hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers.
What you do at Geisinger shapes the future of health and improves lives – for our patients, communities, and you.