Provider Relations Specialist Associate - Remote
Provider Relations Specialist AssociateAt Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve.Looking for a purpose-driven career? Come build the future of pharmacy with us.The Associate Provider Relations Specialist is responsible for conducting outreach to pharmacies participating in Prime's pharmacy networks and ensuring the information provided during outbound communications is accurate and delivered in a timely manner.This position is responsible for managing extension requests for the claims processing time frame and triaging inquiries received in the Pharmacy Network Management email box.Responsibilities :Research claims and conduct pharmacy outreach to support regulatory, client commitments and other initiatives as assignedPrepare pharmacy outreach reporting to internal and external stakeholdersManage and resolve requests to update the transaction control table in order to extend the timely filingResearch, assign and escalate inquiries received through the Pharmacy Provider Relations email boxProcess pharmacy remittance requestsProcess claims reversalsResolve prescriber related CMS Prescription Drug Events (PDE) rejections within the required turnaround timesIdentify and participate in implementing department level process improvementsOther duties as assignedMinimum Qualifications :Bachelor's degree in Business or related area of study, or equivalent combination of education and / or relevant work experience1 year of work experience in a call center, customer service, operations, retail pharmacy, pharmacy technician, or Pharmacy Benefit Manager (PBM)Must be eligible to work in the United States without need for work visa or residency sponsorshipAdditional Qualifications :Demonstrated ability to problem solve complex issues in a timely mannerExcellent customer service and collaboration skillsEnhanced organizational skills with the ability to work on multiple tasks simultaneouslyAbility to work with confidential data and maintain privacyAbility to evaluate and interpret policies and proceduresAbility to work in a fast-paced, collaborative team environmentAdvanced in Microsoft applications such as Outlook, Word and ExcelPreferred Qualifications :Experience working with RxClaim or other claims processing systemsPharmacy Technician certification (CPhT) or equivalent pharmacy experiencePharmacy outreach and outbound call experienceEvery employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.Potential pay for this position ranges from $23.08 - $37.02 based on experience and skills.Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer.We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.Prime Therapeutics LLC is a Tobacco-Free Workplace employer.If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email [email protected]..