Pharmacy Customer Service Representative

Pharmacy Customer Service Representative

The role : We're looking for a 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 based 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 an environment which fosters teamwork, cooperation, respect and diversity.
• Perform other duties and projects as assigned.

Who you are :

Salary : $21-22 / HR

Offer amounts for both remote and in office roles are influenced by geographic location

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 email domain. We will never ask for bank details or deposits of any kind as a condition of employment.

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 $205mm from investors including Khosla Ventures, Thrive Capital, and Tiger Global. We're headquartered in New York City, with satellite offices in Denver and Dallas. 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 :

Rightway is proudly an equal opportunity employer that believes in strength in the diversity of thought processes, beliefs, background and education and fosters an inclusive culture where differences are celebrated to drive the best business decisions possible. We do not discriminate on any basis covered by appropriate law. All employment is decided on the consideration of merit, qualifications, need and performance.