Bilingual Pharmacy Customer Service Representative

Shift Details: Tu/We/Th/Fr/Sa 09:00a - 05:30p EST.

ABOUT THE ROLE:

We’re looking for a Bilingual (English/Spanish) Pharmacy Customer Service Representative who is motivated by our mission to unlock transformational healthcare outcomes.  To simplify the healthcare experience for employers and members, we have created a single digital platform across medical, pharmacy benefits & virtual care. 

Our pharmacy benefit management (PBM) offering represents an important growth area for Rightway.  Helping clients better manage pharmacy spend to make drugs more affordable for their employees and dependents is critical to their business sustainability.  RightwayRx is responsible for designing, building and operating a new-to-the-world PBM model base on our core tenets: fairness & transparency, unlocking the supply chain, supporting the physician-patient relationship, and utilizing navigation to empower consumers

The Pharmacy Customer Service Representative is a member of the RightwayRx Operations team reporting to the Sr Director of PBM Operations. This role works regularly with members and providers to resolve inquiries related to benefits, claim adjudication and utilization management.

WHAT YOU’LL DO:

• Handles calls and correspondence (electronic and written) regarding pharmacy benefit inquiries from providers (pharmacy/physician) and members.
• Effectively communicate issues and resolution to members and providers.
• Document calls within a call tracking system using established protocols to ensure resolutions are clear, concise, and accurate.
• Assist network pharmacies in processing prescription claims. Review claims for accuracy against benefit guidelines and contract standards.
• Serve as a customer advocate in problem resolution and follow through.
• Creates and supports and environment which fosters teamwork, cooperation, respect and diversity.
• Perform other duties and projects as assigned.

WHO YOU ARE:

• Education level: Bachelor’s Degree or equivalent relevant work experience. 
• Active/Current National Pharmacy Technician Certification
• Bilingual in English/Spanish
• Work experience: 3-5 years of relevant work experience in a health plan, TPA or PBM contact center.
• Important characteristics of ideal candidate: Detail-oriented, analytical, intellectually curious, good listener, empathetic, ability to challenge status quo, values exemplar
• Specific skills needed for job: Prior experience working with health plan, TPA, or PBM contact center, effective & creative problem-solver, ability to prioritize and manage through change. Solid communication skills.

SALARY: $21-22/HR

CYBERSECURITY AWARENESS NOTICE

In response to ongoing and industry-wide fraudulent recruitment activities (i.e., job scams), Rightway wants to inform potential candidates that we will only contact them from the @rightwayhealthcare.com email domain. We will never ask for bank details or deposits of any kind as a condition of employment. If you have any questions about a suspicious interaction with Rightway, please feel free to reach out to us at hr@rightwayhealthcare.com.

ABOUT RIGHTWAY:

Rightway is on a mission to harmonize healthcare for everyone, everywhere. Our products guide patients to the best care and medications by inserting clinicians and pharmacists into a patient’s care journey through a modern, mobile app. Rightway is a front door to healthcare, giving patients the tools they need along with on-demand access to Rightway health guides, human experts that answer their questions and manage the frustrating parts of healthcare for them.

Since its founding in 2017, Rightway has raised over $130mm from investors including Khosla Ventures, Thrive Capital, and Tiger Global at a valuation of $1 billion. We’re headquartered in New York City, with a satellite office in Denver. Our clients rely on us to transform the healthcare experience, improve outcomes for their teams, and decrease their healthcare costs.

HOW WE LIVE OUR VALUES TO OUR TEAMMATES:

We’re seeking those with passion for healthcare and relentless devotion to our goal. We need team members who will:

• We are human first - Our humanity binds us together. We bring the same empathetic approach to every individual we engage with, whether it be our members, our clients, or each other. We are all worthy of respect and understanding and we engage in our interactions with c