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Verify appropriate Member and Provider information
Contact patients, pharmacists, and doctor's offices to resolve claims issues
Resolve customer issues; ensuring accurate information is provided
Consistently meet established productivity, schedule adherence, and quality standards while maintaining a good attendance record
Contact doctor's offices to obtain information necessary to determine if the drug claim is covered under the member's pharmacy benefits
Outreach will be performed via phone and electronically (e.g. fax)
Reach out to Members for assistance in securing information from their doctor
Accurate, timely, and detailed documentation of each outreach attempt
Collaborate with pharmacists and medical directors, ensuring coverage criteria is clearly communicated to the physicians and their office personnel
Provider outreach to obtain additional information necessary for the pharmacist or medical director to render a coverage decision
High School Diploma / GED (or higher)
1 years of Pharmacy Technician experience
1 years working experience with Microsoft Word (create, save and report documents) and Microsoft Excel (create, save and report spreadsheets)
1 years of experience with Windows - based applications, including the ability to learn new and complex systems
Current California Pharmacy Technician License
Availability to work an 8 - hour shift, 40 hours per week between 6:00 am - 7:00 pm Monday through Friday including weekends and overtime as required according to the needs of the business
Prior stable work experience
Ability to remain focused and productive each day though tasks may be repetitive
Excellent oral and written communication skills
Physical Requirements and Work Environment:
Frequent speaking, listening using a phone headset, sitting, use of hands / fingers across keyboard or mouse, handling other objects, long periods of close vision looking at a computer monitor
Service Center environment with moderate noise level due to representatives talking, computers, printers, and floor activities
Careerswith UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6organization that's serving more than 85 million people already and buildingthe industry's singular reputation for bold ideas and impeccable execution. Now,add your energy, your passion for excellence, your near - obsession withdriving change for the better. Get the picture? UnitedHealthcare is servingemployers and individuals, states and communities, Military families and Veteranswherever they're found across the globe. We bring them the resources of anindustry leader and a commitment to improve their lives that's second to none.This is no small opportunity. It's where you can do your life's best work.
Diversity creates a healthier atmosphere:UnitedHealth Group is an Equal Employment Opportunity / Affirmative Actionemployer and all qualified applicants will receive consideration for employmentwithout regard to race, color, religion, sex, age, national origin, protectedveteran status, disability status, sexual orientation, gender identity or expression,marital status, genetic information, or any other characteristic protected bylaw.
UnitedHealth Group is a drug - free workplace.Candidates are required to pass a drug test before beginning employment.
Keywords: UHG, Healthcare, UnitedHealth, Cypress, CA, Pharmacy, Appeals
Unitedhealth Group Inc.