Responsibilities

This position is responsible for assisting the Pharmacy Health Plan Services area in the management of the Medicare Advantage Part D prescription benefits. Under the supervision of the Health Plan Pharmacy Manager and/or Supervisor, this position is primarily responsible for triaging and/or resolving pharmacy services phone calls, audits and monitoring functions that help ensure prescription benefits are administered cost effectively, timely, accurately and in compliance with CMS standards. This position also includes, processing coverage determinations per Medicare Part D program regulations and assisting the Health Plan Pharmacy Services department with the management of Kelsey-Seybold Clinics’ Pharmacy Quality Initiatives (i.e. MTMP, Hospital Discharge, RXQI, and Adherence). Additional activities may include scheduling appointments and monitoring functions that help ensure Pharmacy Initiatives are administered efficiently, accurately and in compliance with the departments’ standard operating procedures. This position may conduct outbound calls regarding patient adherence to medications and assist patients to refill medications in a prompt and courteous manner utilizing a PC. This position is also responsible for general clerical duties which include but are not limited to member mailings, verifying addresses for return mail, data entry, processing collection letters and documenting member outcomes. This position confirms appointments and handles cancellations in a timely, efficient and courteous manner. The employee in this position should be able to provide comprehensive service in order to facilitate a resolution to caller requests and triage calls to the appropriate team members when necessary. The employee should acquire and maintain computer skills to effectively utilize software and Windows based programs as well as be able to quickly learn processes and put into practice learned principles.

Job Title: Medicare Advantage Benefits Technician

Clinic Location: Pearland Administrative Office Building

Department: Pharmacy Services

Job Type: Full Time

Salary Range: $44,762 – $55,307 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)

Qualifications

Education

Required: High School diploma or GED from an accredited program

Preferred: Some college or technical school

Experience

Required: 6 months operational pharmacy benefit experience
OR
6 months experience in a high volume call center
OR
6 months of customer service experience
OR
6 months retail pharmacy experience

Preferred: 2 years Medicare Part D experience
2 years high volume call center experience

License(s)

Required: TSBP Registered Pharmacy Technician

Preferred: 2 years HMO 3rd party managed care experience

Special Skills

Required: Good Alpha/Numeric data entry skills with minimal errors. Excellent customer service, telephone etiquette skills, and active listening skills
Proficient 2 with computer applications that including, but not limited to: Microsoft Word, Excel, and Access Demonstrates strong problem solving and analytical skills
Type 20 WPM. 10 key by touch

Preferred: Auditing experience. Ability to exercise good judgment during high call volume while maintaining a professional attitude

Other

Required: Communication skills, professional appearance, and ability to work effectively in a fast paced work environment. Ability to speak, write and understand the English language Detail oriented with excellent verbal and written communication skills

Preferred: Bilingual English/Spanish

Working Environment: Clinic or Office

About Us

Start your career journey and become a part of a community of renowned Healthcare professionals. Kelsey-Seybold Clinic is Houston’s fastest growing, multispecialty organization with more than 40 premier locations and over 65 specialties. Our clinics are comprised of more than 600 physicians and as we continue to grow, our focus is providing quality patient care by adding to our team of clinical and non-clinical professionals that work together in a convenient, coordinated, and collaborative manner. Enjoy the rewards of a successful career while maintaining a work/life balance by joining our team today and changing the way health cares.

Why Kelsey-Seybold Clinic?

• Medical, Vision, and Dental
• Tuition Reimbursement
• Company Matching 401K
• Employee Reward and Recognition Program
• Paid time off for vacation, sick, and holidays
• Employee Assistance Program
• Continuing Medical Education allowance