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Pharmacy Representative II - Specialty Mail

Job ID: 589977BR
Business Area: CVS Health
Primary Location: NJ ‒ Fairfield
Job Type: Full Time
Job Category: Corporate, Customer Service
Clinical Licensure Required: N/A
Location Code OF149
Position Summary:
As a Pharmacy Representative II, you will be a key member of the Specialty Pharmacy by enhancing our members experience within their specific health plan. The purpose of this Pharmacy Representative II is to provide expertise and customer service to our valued members or providers relating to enrollment, refilling of prescription orders, discussing benefits, and any/all other questions in regards to their health plan. As a Pharmacy Representative II, you will be verifying insurance coverage for potential new patients and re-verification of insurance coverage for existing patients in order to process patient prescription needs successfully, reduce expose, and demonstrate excellent customer service to patients, healthcare professionals and insurance carriers.

This facility is open 365 days of the year and the hours of operation are Monday- Friday 7am-9pm, Saturday-Sunday 8am-6:30pm. The schedule is rotating where you will start anywhere from 7am-12pm. The ideal candidate is flexible with the schedule and willing to adapt to any changes

Additional Responsibilities for the Pharmacy Representatives II include:

- Responsible for accurate and timely verification of existing patients’ prescription drug coverage specifically relating to disease state and type of prescriptions, supplies and services requested.

- Review billing system to verify patient’s eligibility to receive medication and update necessary information.

- Contact doctors’ office staff for information to help resolve outstanding claims or insurance issues.

- Accurately quote pricing for medications for a patient and appropriately code and enter text notes into the pharmacy system.

- Update patient on unresolved issues as it relates to coverage status and delays in the processing and receipt of medication orders.

- Additional responsibilities as assigned or deemed necessary for the business unit.

Required Qualifications:
6+ months of experience working with medical insurance or medical billing.

1 + years of experience working in a Windows based system.

Preferred Qualifications:
Previous experience working in a PBM industry.

Excellent customer service skills.

Attention to detail.

Knowledge of government and patient assistance programs.

Understanding of commercial insurance concepts including drug cards and major medical benefits

Analytical and problem solving skills.

Exemplify leadership qualities - Communicate with tact and diplomacy, able to create a cohesive team atmosphere, embrace change positively.

Professional maturity - Work well with others in problem solving situations, look to find positive resolutions to day to day issues.

High School Diploma or Equivalent.

Business Overview:
CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.

CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster:


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