Position Overview: Coordinate application of pharmacy services and benefits as an integral contributor on the pharmacy team. Handle pharmacy-related inquiries and communicate benefit determinations.  Provide pharmacy services helpdesk support to pharmacies, providers, and members. Perform pharmacy authorization and claim processing services. 

This position will work Monday through Friday, 8am-5pm - This is not in a retail environment requiring evening/weekend shifts!

Essential Responsibilities:

• Act as principal contact regarding drug authorizations and system overrides. Help to resolve pharmacy services and benefits inquiries through skillful knowledge of the pharmacy claims, medical claims, and utilization management platforms.
• Initiate clinical review and decision-making of authorization requests under the guidance of clinical pharmacists.
• Effectively communicate and collaborate in a clear and concise manner to internal and external partners, including translating clinical and technical industry jargon to appropriate audiences.
• Function as liaison with pharmacy benefit manager, pharmacies, physicians, and others in order to apply benefits, and assist with pharmacy benefit determinations.
• Consult with clinical pharmacists and other staff in determining coverage for pharmacy-related services and pharmaceuticals.
• Prepare and process member-submitted pharmacy claims in the pharmacy benefit manager’s claims processing system.
• Ensure all coverage determinations are processed in a timely and accurate manner, consistent with Commercial, Medicare & Medicaid regulatory requirements and department policies.
• Serve as primary resource to member and providers for pharmacy questions related to the health plan and in navigating through the health systems.

Work Experience: Minimum two years work in a Pharmacy. Demonstrated ability to work efficiently and effectively with a high attention to detail.

Education, Certificates, Licenses: Minimum high school diploma. Unrestricted pharmacy technician license by the Board of Pharmacy and previously passed National Pharmacy Technician certification exam required. Maintain continuing education requirements for license renewal.

Knowledge:

• Good understanding of Medical Terminology required. Familiarity of CPT/ICD-10 codes, home infusion therapies, and specialty medications helpful. Microsoft Office products including Word, Excel, and Outlook.
• Ability to work under time sensitive deadlines. Ability to prioritize responsibilities, diplomatically, handle demanding situations and manage workload with direct supervision. Demonstrate organizational and time management skills.
• Ability to understand and interpret Federal and State specific regulatory requirements helpful. Ability to communicate effectively across all levels of the business on a consistent basis.

Please submit resume for consideration. 

We are seeking a detail-oriented and customer-focused Healthcare Administrative Support Specialist to provide administrative, data entry, and customer service support in a fast-paced healthcare environment. This role is responsible for maintaining accurate records, assisting patients and internal teams, managing documentation, and supporting daily office operations while ensuring confidentiality and compliance with company policies and healthcare regulations.

Key Responsibilities

• Provide administrative support to healthcare teams and office staff.
• Perform accurate data entry and maintain electronic records and databases.
• Answer incoming phone calls, emails, and customer inquiries in a professional and timely manner.
• Schedule, confirm, and update appointments as needed.
• Verify and update patient, member, or client demographic information.
• Process forms, referrals, authorizations, and other administrative documents.
• Scan, file, and organize electronic and paper records while maintaining data accuracy.
• Resolve routine customer service inquiries and escalate complex issues to the appropriate department.
• Maintain confidentiality of sensitive information in accordance with HIPAA and company policies.
• Assist with reporting, correspondence, and general office administration.
• Collaborate with cross-functional teams to ensure efficient workflow and high-quality service.
• Support additional administrative projects and operational tasks as assigned.

Qualifications

• High school diploma or equivalent required; associate degree preferred.
• One (1) or more years of experience in administrative support, customer service, data entry, or office administration.
• Healthcare experience is preferred but not required.
• Strong computer proficiency, including Microsoft Office Suite and the ability to learn new systems quickly.
• Excellent verbal and written communication skills.
• Strong organizational skills with exceptional attention to detail.
• Ability to prioritize multiple tasks in a fast-paced environment.
• Professional demeanor with a strong customer service focus.
• Ability to handle confidential information with discretion.

ESSENTIAL FUNCTIONS:

Operations

Set up new vendors and maintain vendor records

Research and resolve any outstanding balances on accounts payable accounts, including communications with vendors and departments

Process accounts payable and receivables weekly and/or monthly, based on City policies Cash receipts posting, bank deposits, and various reconciliations Performs reconciliations and makes original or correcting entries to specific accounts, prepares supporting documents, proofs, and schedules

Review of account coding Assist with year end closing processes and the audit process

Perform and assist in several operation functions including accounts payable, accounts receivable, transaction auditing, purchasing, reconciliations, general ledger entries, etc

Prepare and maintain accurate reports and spreadsheets

Maintain internal control in relation to primary duties of position Customer Service

Provide reception coverage at city hall, as needed. This includes answering & transferring incoming phone calls, answering citizen questions, accepting citizen forms and applications, and receiving payments.

Provides customer services to operating departments, answer questions and inquiries related to primary tasks of this position.

KNOWLEDGE, SKILLS & ABILITIES:

Knowledge of:

Bookkeeping best practices

Internal controls concepts

Techniques to locate errors in accounting records

Accounts payable and receivables practices Skills Strong analytical skills and ability to interpret information

A customer service attitude Intermediate level skills in computer spreadsheets, word processing and data entry

Accurate typing skills Ability to organize work with an attention to details Ability to:

Analyze data from varied sources

Communicate clearly both orally and in writing

Establish and maintain effective working relationships with co workers, management, external customers, and the general public

Seasonal Maintenance Workers: May perform a variety of routine, manual, custodial, or service tasks; operate non-CDL vehicles and light construction or maintenance equipment; may perform tasks in the maintenance of city streets, sidewalks, storm sewers, sanitary sewers, traffic, and wastewater treatment plant.

Seasonal Parks Workers: May perform a variety of routine, manual, custodial, or servicing tasks: may operate non-CDL vehicles and light construction or maintenance equipment.  May perform tasks in the maintenance of City parks and facilities, including parks, park buildings, public restrooms, landscape and tree maintenance, carpenter or painter assistant, irrigation, horticulture and may engage with members of the public providing quality customer service.

Positions are 40 hours per week that last between 2 to 6 months in duration up to 1039 hours worked in a calendar year. Days and hours vary depending on assignment.

Minimum Requirements
Valid driver's license, or ability to obtain by date of hire; must pass driving records check and if hired, maintain a driving record that meets the City's standard.  Must also pass a physical exam including drug screen.  For positions that may require driving, must be at least 18 years of age.

Duties Performed

• Performs manual tasks in the maintenance, sanitation, and/or repair of City streets, sewers, grounds, buildings, structures and equipment.
• May assist in performing minor carpentry, maintenance activities involving asphalt,
  crack sealing and concrete repair or preventive work, painting, and other related tasks.
• May assist in leaf collection program.
• May operate non-CDL vehicles and other light equipment; uses chainsaws, power and hand tools.
• May perform custodial duties, such as sweeping, cleaning and sanitizing restrooms, litter pick-up, emptying trash cans, and other related manual tasks.
• May assist in cleaning illegal campsites and graffiti removal.
• May assist in watering, mulching, staking, and pruning trees.
• May perform grounds-keeping duties that includes the operation of landscape, turf, and irrigation tools and equipment.
• May assist with a variety of task in natural areas, including ridgeline, waterway, or wetland maintenance and restoration work, trail work, and the removal of invasive vegetation.
• May erect street and traffic signs; may maintain and paint pavement legends.
• May assist in maintenance and construction of traffic signals and street lighting.
• May handle sewage equipment and clean tankage that contains sewage.
• May place signs, cones, high-level warnings, and/or barricades for safe control of traffic. (Traffic Control Flagger Certification may be required)
• May lay tile or pipe; may place and set manholes or standpipe.
• May perform easement work during maintenance of sanitary sewers.
• May perform smoke testing of sanitary sewers.
• Maintains daily work records.
• May work in confined spaces.
• May assist in the performance of carpentry, plumbing, and painting.
• May operate and maintain hand tools, power equipment, and other light equipment.
• May assist in maintaining tools and minor equipment.
• May perform customer service in providing information to the public.
• Supports and respects diversity in the workplace.
• Performs related duties as assigned. 

Qualifications

• Some experience in general maintenance and/or parks maintenance desirable.
• Must be 18 years of age and hold a valid driver's license. Must pass driving records check and, if hired, maintain a driving record that meets the City's standard.
• Valid ODOT Traffic Control Flagger card desirable for some positions.
• All positions are subject to a criminal background check and pre-employment physical that includes a drug screen. 

For immediate consideration, apply NOW! 

Quantum Recruiters is committed to Affirmative Action and values diversity in its workforce.