What are the responsibilities and job description for the Care Specialist II position at Alto Pharmacy?
Job Summary
Job Description
The Patient and Provider Care experience is an essential part of our mission to build the pharmacy of the future. Our Hub team goes above and beyond for our partners by combining the friendliness of your neighborhood pharmacy with the speed of a fast-moving startup. We believe in changing the traditional pharmacy model for the better to provide a five-star experience.
As a Pharmacy Technician II on the Hub Team, you will use your advanced knowledge working in a pharmacy to prepare and submit benefit investigation inquiries using our custom-built pharmacy management system. Additional responsibilities will include troubleshooting complex cases, such as insurance coverage and prior authorizations. You'll also deliver extraordinary customer service while handling patient, provider, or partner escalations via phone, text, chat, and email.
Accelerate Your Career as You
High-Touch Provider Support: work with providers in navigating pharmacy insurance and inform coverage status for their patients.
Troubleshoot Benefit Investigation Cases: Ensure documents are compliant to each program’s requirements, and work with insurance companies to obtain coverage eligibility, including
Customer Service: Deliver excellent service with a focus on maintaining customer satisfaction
Communication Across Teams: Engage with other teams to support patient needs and improve the overall experience
Escalations Management: Handle patient and provider escalations, providing resolution and ensuring satisfaction
Process Improvement: Provide feedback on common issues or workflow improvements from patient or provider interactions
Standard Workflow Execution: Follow predefined workflows for fulfilling pharmacy needs, adhering to standard timeframes and processes
Empathy & Support: Demonstrate empathy in all interactions, focusing on resolving concerns
Labor Share: In addition to specialized duties, share labor with non-specialized roles by supporting general pharmacy tasks during peak times or when coverage is needed, ensuring smooth operation across both specialized and non-specialized functions.
A Bit About You
Minimum Qualifications:
2 years experience working in a high volume pharmacy
An active pharmacy technician license in good standing with the Colorado or Texas, free of any disciplinary actions
Exceptional knowledge of commercial and government insurance and how to troubleshoot claims
Ability to learn and operate a new pharmacy management system and other relevant equipment
Ability to interpret, transcribe, and troubleshoot prescription information
Ability to perform common math calculations
Preferred Qualifications:
Experience with claims adjudication
Experience submitting and managing Prior Authorizations and TAR's
Experience navigating insurance and provider phone systems and personnel
Additional Information
Additional Physical Job Requirements
Reading English, comprehending, and following simple oral and written instructions.
The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading. Assessing the accuracy, neatness and thoroughness of the work assigned.
Communicating with others to exchange information.
Expressing or exchanging ideas by means of the spoken word; those activities where detailed or important spoken instructions must be conveyed to other workers accurately, loudly, or quickly.
Perceiving the nature of sounds at normal speaking levels with or without correction, and having the ability to receive detailed information through oral communication, and making fine discriminations in sound.
Frequent repeating motions required to operate a computer or phone that may include the wrists, hands and/or fingers.
Environmental Conditions: occasional exposure to low temperatures or high temperatures, outdoor elements such as precipitation and wind, and noisy environments.
Salary and Benefits
Salary Range: $18.50
Commission Eligible: No
Equity Eligible: Yes
Travel: No
Location Requirement: Colorado (Remote) or Texas (Remote)
Employment Requirement: Applicants must be authorized to work for any employer in the U.S. At this time, Alto is unable to sponsor or take over sponsorship of an employment Visa.
Full-time employee benefits become available after 90 days. They include: dental, vision, and multiple group medical plans to choose from, a 401(k) retirement savings plan, group life insurance, accidental death and dismemberment (AD&D) insurance, a flexible spending account (FSA) or health savings account (HSA), commuter benefits, employer-paid short-term disability (STD) and long-term disability (LTD) insurance, and additional supplemental insurance plans (spouse life insurance, legal insurance, an employee assistance program, and a fertility medication discount program). Employees are also offered accrued paid sick time, 11 paid holidays (seven for Pharmacy and Care team members), and eight weeks of paid parental leave for eligible employees.
More Benefits Information Here: https://west.acrisure.com/alto-pharmacy/benefits/
#LI-Remote
Alto Pharmacy is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, gender identity, sexual orientation, age, disability, veteran status, or any other legally protected basis. If you have a disability and require reasonable accommodation during any portion of the application or hiring process, please contact us at CandidateHelp@alto.com.
Alto Pharmacy considers qualified applicants with arrest or conviction records for employment and conducts background checks consistent with applicable law, including the California, Los Angeles County, San Francisco, and New York City Fair Chance laws. We are an E-Verify participating company.
To learn about Alto's privacy practices including compliance with applicable privacy laws, please click here.
Salary : $19
