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Pharmacy Technician
RightwayPharmacy Technician managing pharmacy benefit inquiries and support services at Rightway. Engaging with members, providers, and pharmacies for efficient service delivery across multiple communication channels.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in pharmacy claims adjudication, benefit design, and PBM terminology while providing exceptional member support across multiple communication channels. Proficient in utilizing AI-enabled tools for efficient inquiry resolution and documentation.
Highest-signal resume keywords
National Pharmacy Technician CertificationPharmacy Claims AdjudicationBenefit Design KnowledgeMail Order Pharmacy ExperienceCustomer Service Excellence
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims ProcessingMedication Cost AnalysisPrior Authorization CriteriaOperational ReportingDocumentation Accuracy
Soft Skills
EmpathyAnalytical ThinkingAdaptabilityMultitaskingTeam Collaboration
Tools & Technologies
AI-Enabled ToolsInternal Knowledge Systems
Certifications & Qualifications
Active/Current National Pharmacy Technician Certification
Industry Keywords
Health PlanRetail PharmacyTPAPBMSpecialty Pharmacy
About the role
Key responsibilities & impact- Serve as the primary point of contact for members, providers, and pharmacies across phone, chat, email, and written correspondence, delivering timely and accurate support regardless of communication channel.
- Field and resolve inquiries related to mail order, benefit design, formulary coverage, medication cost, prior authorization criteria, and claims adjudication.
- Seamlessly support interactions across phone, chat, email, and other digital channels while maintaining consistent quality and service standards.
- Assist network pharmacies in processing prescription claims, reviewing claims for accuracy against benefit guidelines and contract standards.
- Support clinical pharmacists with patient and provider outreach, including scheduling appointments, enrolling members in Rightway clinical programs, and following up on medication adherence.
- Accurately document interactions and resolutions within internal systems to support continuity of care, quality assurance, compliance requirements, and operational reporting.
- Take ownership of member, provider, and pharmacy issues from initial contact through final resolution, coordinating with internal teams when necessary to ensure timely and complete resolution.
- Utilize AI-enabled tools and internal knowledge systems to efficiently resolve inquiries, document interactions, and deliver a consistent member experience.
- Foster a team environment that values cooperation, respect, and diversity, and take on other duties and projects as assigned.
Requirements
What you’ll need- Education: associate's or bachelor's degree preferred, or equivalent relevant work experience.
- Certification: Active/Current National Pharmacy Technician Certification (PTCB, NHA)
- Experience: 1 to 3 years as a pharmacy technician in a health plan, retail pharmacy setting, TPA, or PBM contact center role. Mail order and specialty pharmacy backgrounds are also a strong fit.
- Working knowledge of pharmacy claims adjudication, benefit design, and PBM terminology.
- Detail oriented, adaptable, and analytical, with the ability to dig past a symptom to find and resolve the true root cause.
- Empathetic and intellectually curious, with a genuine desire to improve a member's healthcare experience and deliver concierge level service across every channel.
- Comfortable multitasking and prioritizing across concurrent phone, chat, and email queues, with the independence to manage your own workload.
- Comfortable supporting multiple lines of business and shifting priorities based on business needs, seasonal demand, and service levels.
Benefits
Comp & perks- Health insurance
- Retirement plans
- Paid time off
- Flexible work arrangements
- Professional development
- Cybersecurity awareness training