Customer Care Pharmacy Support Specialist

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

💝 Customer Support

👻 Ghost score 10%

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WellDyne

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1990

🏥 Healthcare

💊 Pharmaceuticals

⚕️ Healthcare Insurance

Healthcare • Pharmaceuticals • Healthcare Insurance

WellDyne is a pharmacy benefit management (PBM) company that provides specialty pharmacy services, prescription discount solutions, utilization management, mail-order and central fill pharmacy operations, and outsourced pharmacy solutions. The company emphasizes clinical programs, adherence initiatives, data analytics, and personalized engagement to reduce drug costs and improve outcomes, particularly for high-cost specialty medications. With about 25 years of experience and locations in Lakeland, FL and Centennial, CO, WellDyne positions itself as an alternative to traditional PBM models by offering flexible plan design, dedicated account management, and industry-focused clinical expertise.

📋 Description

• Provide advanced support for complex patient, pharmacy, provider, and client inquiries across supported lines of business • Validate claim information, eligibility, benefit requirements, and other applicable information before authorized claim reprocessing • Reprocess pharmacy claims for authorized partner clients according to client requirements, approved procedures, system permissions, and regulations • Serve as a subject matter expert and escalation resource for Customer Care Advocates regarding pharmacy benefits, claims, systems, and client-specific processes • Follow up with patients to ensure medication orders are processed • Support patients, providers, and members with pharmacy mail order coordination • Handle sensitive and escalated customer interactions requiring advanced research, judgment, and problem-solving • Perform authorized pharmacy technician functions within applicable laws, regulations, organizational procedures, and defined scope • Perform additional duties as assigned • Report to the Manager or Supervisor, Customer Care

🎯 Requirements

• High school diploma or equivalent required • Active Pharmacy Technician registration, license or certification required • Certified Pharmacy Technician (CPhT) credential preferred • 1–2 years pharmacy/customer service experience preferred • Experience processing or reprocessing pharmacy benefit claims strongly preferred • Ability to reprocess pharmacy claims accurately within assigned system permissions and established procedures • Strong analytical, troubleshooting, critical-thinking, and problem-solving skills • Ability to distinguish issues requiring pharmacist, clinical, configuration, compliance, or leadership intervention • Ability to work independently and collaboratively in a fast-paced Customer Care environment • Ability to maintain confidentiality and handle sensitive information with integrity • Compliance with HIPAA, applicable pharmacy requirements, client requirements, and organizational policies

🏖️ Benefits

• Equal opportunity employer and nondiscrimination commitment • Monday-to-Friday shift options • Remote work stated in the position location

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