Position:  Customer Care Pharmacy Support Specialist
Location:  Remote
Job Id:  810
# of Openings:  3
At our company, we move fast, adapt quickly, and turn challenges into opportunities—all while keeping quality at the heart of everything we do. We believe that work should be a positive and respectful place, and that with the right mindset, anything is achievable.
Our Vision: 
Fulfill the essential promise of pharmacy care and help people to live to their healthiest, happiest, and fullest potential.
Our Mission: 
To be the disruptive force that drives meaningful change within pharmacy services.
Shifts: Monday to Friday:  
  • 8am-430pm
  • 9am-530pm
  • 930am-6pm
Summary
The Customer Care Pharmacy Support Specialist is a Customer Care position responsible for supporting partner clients, patients and providers with pharmacy and prescription claim inquiries. This role combines inbound contact center and expertise with pharmacy technician knowledge and the ability to research, troubleshoot, and reprocess pharmacy claims for authorized partner clients. The position serves as a subject matter expert and 
analytical resource within Customer Care while collaborating with the Pharmacy, Client Services, and Operations. Success in this role is demonstrated through accurate claim resolution, quality customer experiences, appropriate claim reprocessing, and adherence to client, regulatory, and organizational requirements. This position reports to the Manager or Supervisor, Customer Care.
 
Essential Duties and Responsibilities
  • Provide advanced support for complex patient, pharmacy, provider, and client inquiries across supported lines of business.
  • Validate claim information, eligibility, benefit requirements, and other applicable information before initiating an authorized claim reprocessing transaction.
  • Reprocess pharmacy claims for authorized partner clients in accordance with client-specific requirements, approved procedures, assigned system permissions, and applicable regulatory requirements.
  • Serve as a subject matter expert and escalation resource for Customer Care 
  • Advocates regarding pharmacy benefits, claims, systems, and client-specific processes.
  • Follow-up with patients as needed to ensure medication orders are processed.
  • Support patients, providers and members with pharmacy mail order coordination.
  • Handle sensitive and escalated customer interactions requiring advanced research, judgment, and problem-solving.
  • Perform authorized pharmacy technician functions within applicable laws, regulations, organizational procedures, and the defined scope of the position.
  • Ensure compliance with HIPAA, applicable pharmacy requirements, client requirements, and organizational policies.
  • Perform additional duties as assigned.
Education and Experience
  • High school diploma or equivalent required.
  • Active Pharmacy Technician registration, license or certification required.
  • Certified Pharmacy Technician (CPhT) credential preferred.
  • 1-2 years pharmacy/customer service experience preferred.
  • Experience processing or reprocessing pharmacy benefit claims strongly preferred.
 
Knowledge, Skills and Abilities
  • Experience processing or reprocessing pharmacy benefit claims strongly preferred.
  • Ability to reprocess pharmacy claims accurately within assigned system 
  • permissions and established procedures.
  • Strong analytical, troubleshooting, critical-thinking, and problem-solving skills.
  • Ability to distinguish issues that can be resolved operationally from those requiring 
  • pharmacist, clinical, configuration, compliance, or leadership intervention.
  • Ability to work independently and collaboratively in a fast-paced Customer Care 
  • environment.
  • Ability to maintain confidentiality and handle sensitive information with integrity.
 
Work Environment / Physical Demands
This position is in a typical office environment which requires prolonged sitting in front of a computer. Requires hand-eye coordination and manual dexterity sufficient to operate standard office equipment including operation of standard computer and phone equipment. May have occasional high stress when dealing with customers/clients. Some travel may be required.
EOE M/F/D/V – WellDyne and HealthDyne are equal opportunity employer and prohibits discrimination of any kind. All employment decisions are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, veteran or disability status, or any other protected status under federal, state, or local law.
Apply for this Position
Go back to the job list



WellDyne