State Licensed Pharmacy Representative

Job Summary

Providing essential customer service support, the full-time State Licensed Pharmacy Representative will manage inbound and outbound pharmacy calls, coordinate prior authorization requests, and explain claims adjudication processes to members, providers, and pharmacies.

Key responsibilities

• Handles and records pharmacy calls in compliance with regulations and guidelines
• Processes prior authorization requests and assists with coverage determinations
• Maintains call quality standards while effectively communicating plan benefit information

Required qualifications

• At least 1 year of related experience in call center or customer service
• Proficiency in Microsoft Office suite and applicable software programs
• Ability to work independently and manage multiple projects
• Excellent customer service skills and phone etiquette
• Strong ability to develop and maintain positive work relationships