Pharmacy Customer Service Representative - State of Utah : Job Details

Salary: $21.00 - $36.26 Hourly Location : Salt Lake County, UT Job Type: Full Time Remote Employment: Flexible/Hybrid Job Number: 45919 Agency: 250 Health & Human Services Unit: 3100 DHHS DIH Directors Office Opening Date: 08/15/2025 Closing Date: 8/25/2025 11:59 PM Mountain FLSA: Non-Exempt Recruiter: Angie Rhodes, [email protected] # of Openings: 1 Schedule Code: TL - Time Limited - This is a career service exempt at will position. Background Check: You must successfully pass a criminal history check. Location: Cannon Health Building288 North 1460 WestSalt Lake City UT 84116 The Utah Department of Health and Human Services, Cannon Health Building is proud to be a tobacco free campus. Schedule Code Description: This position is career service exempt (schedule TL) that may convert to career service (schedule B) in the future. Benefits: This position is eligible for a full benefits package. See benefits tab below for details. EEO Statement: The State of Utah is committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. We also consider qualified applicants regardless of criminal histories, consistent with legal requirements. For accommodations, dial 711 or TTY: 800-###-####. Job Description The Pharmacy Customer Service Representative serves as the initial point of contact for inquiries related to Utah Medicaid Pharmacy Services, including: claims adjudication, prior authorization details, and pharmacy-related policy questions. This role also provides administrative support to the clinical team through data entry and other tasks associated with the pharmacy prior authorization process. Responsibilities

• Deliver accurate and professional assistance to members, providers, and internal teams
• Document all interactions and outcomes within the appropriate internal systems
• Assist the clinical team with administrative tasks including data entry for prior authorization reviews
• Adhere to HIPAA regulations and organizational policies at all times
• Handle incoming phone calls related to:
  • Pharmacy claims adjudication issues
  • Prior authorization requirements, status updates, and general inquiries
  • Pharmacy policy interpretation and clarification

Qualifications

• Minimum of one year of customer service experience, preferably in a healthcare, pharmacy or insurance environment
• Strong communtion skills and the ability to manage complex inquires efficiently
• Proficiency in using computer systems and working in a fast-paced, detail-driven environment
• Applicants with experience in pharmacy claims processing and related operations may be given preference.

Work Schedule

• Full-time, 40 hours per week
• Shifts scheduled Monday through Friday between 8:00 am and 6:00 pm.

Note: as of April 8, 2024, DHHS employees will be working a hybrid schedule, which includes 2 office days per week and 3 telework days. Why work for the Utah Department of Health and Human Services? In addition to the rich the State of Utah offers, the department offers:

• On-site fitness center, for a minimal membership fee
• UTA Eco Pass, at a discounted monthly rate
• Teleworking opportunities with a minimum 2 office days per week beginning 04/2024.
• On-site day care center at the Cannon Health Building with First Steps Day Care - contact for rates and availability, 385-###-#### or

For more information on the Utah Department of Health and Human Services, please click If offered this position, your employment will be contingent upon passing a background check and review. There will be no cost to you for this check. This check will include fingerprinting, which will be available at various DHHS locations for your convenience. Fingerprinting will be completed prior to your first day of employment. You may review the policy by clicking here. Supplemental Information

• Effective July 1, 2021, State of Utah Employees must either reside in Utah or be in the process of relocating to Utah within 30 days of their start date.
• This position may currently be a hybrid of both in-office and remote work days. Please note, a position's eligibility for remote work is established by agency management and is subject to change at their discretion, at any time, and for any reason.
• Risks found in the typical office setting, which is adequately lighted, heated and ventilated, e.g., safe use of office equipment, avoiding trips and falls, observing fire regulations, etc.
• Typically, the employee may sit comfortably to perform the work; however, there may be some walking; standing; bending; carrying light items; driving an automobile, etc. Special physical demands are not required to perform the work.

Benefits: The State of Utah offers eligible employees a variety of benefits including medical, dental, life and disability insurance, as well as a comprehensive leave program. Please click the following link for a detailed information page: To access a Total Compensation Calculator in Excel format click FMLA General Notice: (right click + open link in new tab) (clic derecho + abrir en una pestaña nueva?) 01 Your answers to the questions on this posting must be supported by the duties, experience, andinformation listed in your profile's work and education history, not your resume. Please select YES to indicate you understand the validity of your claims will be based upon information contained within your application, not your resume. Unsubstantiated claims, exclusion of information, or incomplete answers may result in the disqualification of your application or of the question. Entering see resume will be considered an incomplete answer.

• Yes

02 Please indicate how you heard about this specific job posting.

• State of Utah job site (www.governmentjobs.com/careers/utah)
• Referred by a Friend or Family
• Indeed
• Other External Job Board or Site
• LinkedIn
• Social Media (Facebook, Twitter, etc.)
• DWS job website (www.jobs.utah.gov)
• Advertisement (Digital Ad, Billboard, Print, etc.)
• Professional Network (Association, Membership, Work Colleague)
• University Network (Handshake, School Job Board, Career Center, etc.)
• Contacted by a Recruiter
• Career or Job Fair
• Internship
• Interviewed for different position
• Internal communications (Agency/Division, etc.)
• Other (not listed above)

03 In applying for this position, I understand that any offer of employment would be contingent upon me successfully completing a background screening as per the Utah Department of Health and Human Services Background Screening Policy and that my start date might change if the background check is not back by the original start date. . Link to the policy can be found in the job description.

• Yes

04 Are you a current employee of the Utah Department of Health and Human Services (DHHS)?

• Yes
• No

05 Please indicate your total years of experience processing pharmacy claims.

• No experience
• Less than 1 year
• 1-2 years
• 3-4 years
• 5 or more years

06 Please briefly describe your experience processing pharmacy claims. Include your job title, dates of employment, and the employer's name. 07 Please indicate your total years of experience processing medical claims.

• No experience
• Less than 1 year
• 1-2 years
• 3-4 years
• 5 or more years

08 Please describe your customer service experience, particularly in a healthcare, pharmacy, or insurance-related setting. Include your job title, dates of employment, and the employer's name. 09 Please indicate your total years of experience with prior authorization processes or reviews.

• No experience
• Less than 1 year
• 1-2 years
• 3-4 years
• 5 or more years

10 Please describe your experience working with prior authorization processes or reviews. Include your job title, dates of employment, and the employer's name. 11 Please rate your overall experience with productivity software applications such as Microsoft Office (Word, Excel, Access, PowerPoint) and Google Workspace (Gmail, Sheets, Docs, etc.).

• No experience
• Limited experience
• Moderate experience
• Extensive experience

12 Please describe your experience using Microsoft Office and Google Workspace applications. Include examples of the types of projects or assignments completed, as well as your job title, dates of employment, and employer name. Required Question