Posted in Other 8 days ago.
Location: Irving, TX
Description: Our client is currently seeking a Client Services Technician I
The Client Services Technician reports to the Client Services Supervisor and is responsible for standard system coding, maintenance, and quality assurance in the internal system, including building out standard plan designs, rates, clinical programs, and pharmacy networks. Additionally, this role serves as the important first line of contact for our clients, providing them accurate information to help resolve any issues and/or concerns. They are essentially the subject matter expert for all matters related to clients and vendors
Essential Roles and Responsibilities
• Analyze standard and customized coding requests and work with internal teams to obtain the accurate and complete plan documentation needed to code client intent into the internal system.
• Implement new and maintain existing benefit plans, rates, and networks in the system, consistent with the direction and intent set forth by the client and vendors
• Work collaboratively with the Quality Specialist to perform pre- and post-implementation claim testing and other configuration quality reviews to ensure accurate claim adjudication and adherence to standard and custom design requirements.
• Identify discrepancies, inaccuracies and unintended consequences, and take corrective action.
• Research and respond to claims processing and system configuration inquiries from internal departments.
• Proactively identify setup service issues and escalate to the Client Service Supervisor or Manager for immediate review and resolution.
Professional Experience and Skills Requirements:
• Pharmacy Technician Associate Degree or equivalent professional experience.
• One (1) year or more of experience in a PBM/Health Plan Environment or; Retail Pharmacy or proven experience as a data analyst.
• Proficiency in the use of Microsoft Tools: Excel, Word, Outlook, Office 365 and Power Point.
• Knowledge of Federal and The Commonwealth of Puerto Rico health care delivery and pharmacy regulations / regulatory agencies, preferred.
• Must be able to type a minimum of 35wpm and have the ability to multi-task moving from multiple screens on dual monitors
• Fully bilingual: Spanish and English.
• Excellent time management and organizational ability.
• Ability to multitask and meet constant deadlines.