XTN-8381388 | CUSTOMER SERVICE REPRESENTATIVE I

Provides customer service to pharmacies, physicians, health plan sponsors, and their members by responding to and resolving phone inquiries related to benefit information, claims adjudication, eligibility verification, prior authorization, and other PBM processes.

Requirements

• Convey a positive image of the company by promptly responding to customer phone inquiries and determining the appropriate actions to resolve issues, gather and provide information, and offer assistance.
• Deliver service that meets or exceeds department performance standards for Average Hold Time, Abandonment Rate, Talk Time, Quality, Adherence, and One-touch Resolution.
• Utilize multiple company database programs to research and resolve complex issues relating to benefit information, claims adjudication, eligibility verification, prior authorization, and other PBM processes.
• Educate external customers about MedImpact’s roles and responsibilities and provide information about override guidelines, benefit plan restrictions, prior authorization requirements, grievance and appeal processes, and other PBM functions as specified by health plan sponsors in online CS Notes.
• Follow up with callers as appropriate to ensure customer satisfaction and timely response to requests.
• Diffuse irate or emotionally upset customers by appropriately listening to issues, calming the customer, and providing positive solutions to resolve concerns.
• Represent MedImpact in a positive manner by adhering to SMART processes and established procedures and guidelines.
• Identify opportunities and make recommendations to department leadership for improvement of workflow processes, operating systems, training programs, reference materials, and quality initiatives that enhance the customer experience.
• Keep current on new plan information and instructions by attending and participating in staff meetings, RTL’s, company-required training programs, and other activities that develop skills, build teamwork, and provide updated information.

Benefits

• Health Insurance/HMO
• Unlimited MadMax Coffee
• Diverse learning & growth opportunities
• Accessible Cloud HR platform (Sprout)
• Above standard leaves