Department

Job Title

Capital Rx is redefining the way prescriptions are priced and administered in the U.S. Capital Rx unlocks the pharmacy supply chain and reduces prescription costs for employer groups. By establishing a competitive marketplace for drug pricing, Capital Rx focuses its resources on deploying actionable strategies that improve plan performance and patient outcomes. The company's commitment to innovation, technology, and service is why Capital Rx is the fastest-growing pharmacy benefit manager in America.

Customer Care Agents

Customer Care Pharmacy Technician (Full-Time)

We have an exciting full-time opportunity at Capital Rx!

Location: Remote

Shifts: Candidates must be open to working any shift.

About Capital Rx

Capital Rx is a next generation pharmacy benefits manager, overseeing prescription benefit plans on behalf of employers, unions, and government entities. Determined to transform an outdated model, Capital Rx’s mission is to change the way prescription benefits are priced and administered in the US, unlocking enduring social change. Through our platform approach, Capital Rx delivers data-driven insights and actionable strategies that reduce costs, while improving patient outcomes. Our commitment to innovation, technology and service is the reason why Capital Rx is among the fastest-growing PBMs in the country.

Position Responsibilities:

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• Serve as first point of contact for incoming, prior authorization inquiries and appropriately escalates cases and all intake notes to the Clinical Prior Authorization Team
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• Actively intake a thorough and complete prior authorization request from prescribers and members by asking applicable drug and client specific clinical questions
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• Accurately advise callers on options for exception requests (formulary, copay, early refill, etc.) based on client benefit elections and provide additional information and status updates to prescribers, members, and pharmacies
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• Triage incoming phone calls from providers with minimal support and ask probing questions to identify and resolve all issues and address concerns expediently
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• Serve as a point of escalation for Customer Service Representatives handling member and pharmacy calls and serve as a backup based on availability and volume as necessary
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• Identify, document, and escalate provider concerns to the appropriate internal team including various members of the Operations Team
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• Effectively communicate issues and resolutions to providers and appropriate internal stakeholders to ensure customers receive quality care and the resolution meets all health and safety standards
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• Ensure customer satisfaction, extraordinary customer care, and quality resolution with genuine compassion in a fast paced, startup environment
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• Follow all internal Standard Operating Procedures and adhere to HIPAA guidelines and Company policies
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• Support the Fraud, Waste, and Abuse program by reviewing pharmacy claims information and communicating findings to appropriate internal staff
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• Perform other customer support duties as assigned
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Required Qualifications:

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• High school diploma or the equivalent; Associates or Bachelors degree preferred
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• National Certified Pharmacy Technician (CPhT) license required
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• 2+ years of pharmacy technician experience in a clinical pharmacy setting PBM, Health Plan, or related Health Care experience required
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• 2+ year of customer service experience with a passion for building customer loyalty through exceptional listening, relationship building, and strong written and verbal communication
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• Experience handling prior authorization requests/understanding of prior authorization requirements preferred
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• Ability to work independently with minimal supervision, stay productive in a remote, high-volume, metric driven call center environment
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• Bilingual Spanish preferred
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• Medicare experience preferred
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Hourly Rate Minimum: $28.00

Hourly Rate Maximum: $28.00

This range represents the low and high end of the anticipated base salary range for the NY - based position. The actual base salary will depend on several factors such as: experience, knowledge, and skills, and if the location of the job changes.

Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.