Pharmacy Help Desk Call Center Representative

Job overview

The Pharmacy Help Desk Call Center Representative role is based in 00968, PR, and the listing does not specify a remote arrangement. Compensation is not specified. The representative reports to the Pharmacy Help Desk Call Center Supervisor and supports pharmacy help desk operations. The role provides telephone customer service to pharmacies, providers, and beneficiaries, helping resolve claim, reimbursement, payment, and related issues. It supports accurate case handling by documenting inquiries, routing cases, monitoring point-of-sale rejections, and following HIPAA and pharmacy-law standards.

What you'll do

• Answer incoming pharmacy, provider, and beneficiary calls
• make outbound calls when needed
• research issues and provide solutions
• document inquiries in customer service management applications
• route cases to internal departments or health insurance carriers
• guide callers on claim transmission, reimbursement, and payment processes
• monitor the BACMAN Alert Application
• evaluate coverage-determination criteria for alerts and rejections
• identify and route system issues
• support Quality Management Program initiatives.

What we're looking for

Skills & competencies

pharmacy help desk

call center representative

pharmacy claims

customer service

provider support

beneficiary support

hipaa

claim reimbursement

payment support

case documentation

pharmpix

Work arrangement

• Weekend coverage required

About the employer

Pharmpix is hiring for this role. Industry: Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds. Sector: 52.