Efficiently triage incoming phone calls with professional phone etiquette from members and pharmacies with minimal support. Ask probing questions to identify and resolve all issues and address concerns promptly
Provide support for call center staff, including other technicians and customer service representatives
Identify, accurately document, and escalate member and pharmacy concerns to the appropriate internal team including various members of the Operations Team
Effectively communicate issues and solutions to members, pharmacies, and relevant internal stakeholders to ensure customers receive quality care and that the resolution meets all health and safety standards
Communicate effectively with internal and external customers to provide first-call resolution and de-escalate customer concerns
Ensure customer satisfaction, extraordinary customer care, and quality resolution with genuine compassion in a fast-paced, environment
Follow all internal Standard Operating Procedures and adhere to HIPAA guidelines and Company policies
Support the Fraud, Waste, and Abuse program by reviewing pharmacy claims information and communicating findings to appropriate internal staff
Work with multiple systems, up to 2 monitors, and multitask in a fast-paced environment
Self-starter who displays a positive attitude, strong work ethic, and excellent attendance
Meet all departmental goals including schedule adherence, attendance, and quality monitoring
Standard hours for training: Monday thru Friday, 9:00am – 5:30pm, Eastern
Perform other customer support duties as assigned
Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance
Requirements
High school diploma or the equivalent; Associates or Bachelor’s degree preferred
2+ years of customer service, call center, and/or health care experience with a passion for building customer loyalty through exceptional listening, relationship building, and strong written and verbal communication preferred
2+ years of PBM or related Health Care experience required
Ability to work independently with minimal supervision, stay productive in a remote, high-volume, fast-paced, metric-driven call center environment