Pharmacy Customer Associate III - Benefit Investigation

Anticipated End Date:

2025-08-01

Position Title:

Pharmacy Customer Associate III - Benefit Investigation

Job Description:

Be Part of an Extraordinary Team 

BioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of companies. Together, CarelonRx and BioPlus offer consumers and providers an unparalleled level of service that’s easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer’s treatment journey.

Pharmacy Customer Associate III

Location: TX-SAN ANTONIO, 4751 HAMILTON WOLF RD, STE 101

ONSITE 5 Days/week: This role requires associates to work from the posted locations full-time, enabling consistent face-to-face collaboration, teamwork, and direct engagement. This policy promotes an environment built on in-person interaction, communication, and immediate support.

The Pharmacy Customer Associate III is responsible for managing our intake process and ensuring accurate benefits investigation to support patient access to specialty medications. This position requires a collaborative professional who can efficiently handle prescription volumes, update patient records, and liaise with team members to secure paid pharmacy claims.

How you will make an impact:

Primary duties may include, but are not limited to:

• Oversee prescription processing with accuracy, maintaining confidentiality and HIPAA compliance, while ensuring coordination of patient care and adherence to 340B program and company standards.

• Act as a subject matter expert, advocating for patient access to specialty medications, resolving complex benefit issues, and leading improvements in workflow and service delivery.

• Interacts with internal and external customers (could include subscribers, providers, group or benefit administrators, physician offices, third party representatives, and other Blue Cross Plans) to provide claims, customer service, and/or membership support.

• Responds to client issues via telephone and written correspondence regarding insurance benefits member, provider contracts, eligibility, claims, etc.

• Completes necessary research to provide proactive, thorough solutions.

• Displays ownership of service requests ensuring high quality resolution and follow-thru.

• Supports and guides the customer with their personal options and decisions and helps the customer become knowledgeable and confident about using technology, tools and resources available to them.

• Promotes process improvement opportunities including responding to suggestions communicated by customers.

Minimum requirements:

• Requires HS diploma or equivalent and a minimum of 3 years of experience; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Minimum of 2 years of experience in healthcare, pharmacy, or related services, preferred.

• Knowledge of the 340B program and experience with specialty medications is highly preferred.

• Certified Pharmacy Technician (CPhT) or related certification preferred.

• Familiarity with benefits investigation and pharmacy PBM processes, preferred.

• Strong organizational skills and attention to detail, preferred.

• Excellent communication, organizational, and problem-solving skills, preferred.

• Proficiency in using healthcare information systems and Microsoft Office applications, preferred.

• General knowledge of company pharmacy services, products, insurance benefits, contracts and claims preferred.

For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Job Level:

Non-Management Non-Exempt

Workshift:

Job Family:

CUS > Care Reps

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

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