Medicare Advantage Benefits Technician

About the position Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together. Responsibilities • Assist the Pharmacy Health Plan Services area in the management of the Medicare Advantage Part D prescription benefits. • Triage and/or resolve pharmacy services phone calls, audits, and monitoring functions to ensure prescription benefits are administered cost effectively, timely, accurately, and in compliance with CMS standards. • Process coverage determinations per Medicare Part D program regulations. • Assist the Health Plan Pharmacy Services department with the management of Kelsey-Seybold Clinics' Pharmacy Quality Initiatives (i.e. MTMP, Hospital Discharge, RXQI, and Adherence). • Schedule appointments and monitor functions to ensure Pharmacy Initiatives are administered efficiently and accurately. • Conduct outbound calls regarding patient adherence to medications and assist patients to refill medications in a prompt and courteous manner. • Perform general clerical duties including member mailings, verifying addresses for return mail, data entry, processing collection letters, and documenting member outcomes. • Confirm appointments and handle cancellations in a timely, efficient, and courteous manner. • Provide comprehensive service to facilitate resolution to caller requests and triage calls to appropriate team members when necessary. • Acquire and maintain computer skills to effectively utilize software and Windows based programs. Requirements • High School diploma or GED from an accredited program. • TSBP Registered Pharmacy Technician. • 6+ months of operational pharmacy benefit experience OR 6+ months of experience in a high volume call center OR 6+ months of customer service experience OR 6+ months of retail pharmacy experience. • Good Alpha/Numeric data entry skills with minimal errors. • Excellent customer service, telephone etiquette skills, and active listening skills. • Proficient with computer applications including Microsoft Word, Excel, and Access. • Demonstrated solid problem solving and analytical skills. • Ability to Type 20 WPM. 10 key by touch. Nice-to-haves • Some college or technical school. • 2+ years of Medicare Part D experience. • 2+ years of high volume call center experience. • 2+ years of HMO 3rd party managed care experience. • Auditing experience. • Ability to exercise good judgment during high call volume while maintaining a professional attitude. • Bilingual English/Spanish. Benefits • Comprehensive benefits package. • Incentive and recognition programs. • Equity stock purchase. • 401k contribution. Apply tot his job