Pharmacy Member Services - 260053

Pharmacy Member Services Representative

Location: Onsite 93711Compensation: $21.00 – $23.00/hour (based on pharmacy technician certification/licensure)Position OverviewAs a Patient Services Representative, you will serve as the primary point of contact for patients, retail pharmacies, and clients.

You will provide clear, compassionate, and accurate support across phone, email, and chat—answering benefit questions, navigating claims, and assisting with prior authorizations. With dedicated onboarding and a commitment to first-call resolution, you will help simplify complex healthcare processes for callers every day.What You’ll DoOmnichannel Support: Handle inbound inquiries from patients, pharmacies, and plan sponsors across multiple channels (phone, chat, email) with professionalism and empathy.Benefits & Claims Navigation: Review pharmacy benefit details, troubleshoot claim submissions, and communicate coverage clearly to members.Prior Authorization Support: Provide call support for prior authorization requests and log cases accurately in the ticketing system.Issue Resolution: Take ownership of inquiries from start to finish, escalating complex clinical or administrative cases when necessary.Documentation & Queue Management: Maintain thorough, HIPAA-compliant records of every interaction and assist in keeping pharmacy outreach queues current.Schedule & TrainingTraining (Weeks 1–4): Monday – Friday, 7:30 AM – 4:30 PM PST.Regular Schedule: Consistent, static Monday – Friday schedule 11 AM- 7 PMWeekend Rotation: Approximately one weekend shift (Saturday or Sunday) every 6 weeks, paired with an alternate weekday off.Required QualificationsHigh school diploma or GED equivalent.Customer service experience, preferably in a call center, pharmacy, or healthcare setting.Proficiency with Microsoft Office Suite (Word, Excel, Outlook, Teams) and ticketing systems.Strong verbal and written communication skills with active listening ability.Ability to multitask in a fast-paced environment while maintaining high accuracy and patient-first care.Flexibility to work assigned shifts within operating hours.Preferred QualificationsCurrent National Pharmacy Technician Certification (PTCB or ExCPT) and/or state Pharmacy Technician License in good standing.Prior experience in Pharmacy Benefit Management (PBM), retail pharmacy, or specialty pharmacy operations.Experience handling healthcare or prior authorization calls.Associate or Bachelor’s degree in a related field.