Pharmacy Synergistics Inc

Assist Medicare members with rejected pharmacy claims and process prior authorizations in coordination with providers. Manage escalated service issues, conduct outbound service calls for adherence, and maintain compliance with quality standards.

The representative will serve as a primary contact for Medicare members, providers, and pharmacies to resolve prescription benefit issues and coordinate prior authorizations. They will also conduct outbound outreach for medication adherence and document all interactions according to regulatory standards.

The LPN will provide clinical services during member health planning events and in-home visits, including screenings and health coaching. Additionally, the role involves conducting outreach calls and providing follow-up support to improve chronic disease outcomes.