· Responsible for answering inbound calls in a timely manner from members, member representatives, agent brokers, providers, health plan employees, employees and clients.
· Responsible to complete research using provided resources to ensure accurate and quality service is being delivered as contracted with the client while remaining within CMS guidelines and adhering to department internal policies and procedures.
· Outbound calls are periodically required for surveys and resolution of outstanding issues.
· Performs as an advocate by educating the caller of all necessary information and alternatives as it relates to the call to promote one call resolution and develop and maintain effective working relationships with internal and external customers.
· High school diploma or GED
· 2 years of customer service experience
· Knowledge of professional telephone etiquette and soft skills
· Analytical and problem solving skills
· PC proficiency to include Microsoft Office Excel, Word and Outlook
· Clear and concise verbal and written communication skills.
· Ability to work scheduled hours. Overtime may be required including evenings, nights, weekends, and holidays.
Preferred Job Requirements
· Healthcare customer service experience
· Knowledge of standard concepts, practices and procedures with dispensing pharmacies
· Knowledge of Facets and AS400 applications
Compensation TypeFull Time - Hourly
ExperienceAt Least One Year
QualificationHigh School Diploma