Customer Service Representative I

MedImpact•Tempe, AZ

1d•$16 - $25•Onsite

About The Position

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team! Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare. At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution! Job Description Summary Provides outstanding customer service to pharmacies, physicians, health plan sponsors, and their members, beneficiaries, or employees by responding to and resolving phone inquiries related to benefit information, claims adjudication, eligibility verification, prior authorization, and other PBM processes. Works under general supervision, relying upon instructions, work process guidelines, policies & procedures, and company knowledge/experience to perform the functions of the job. The extent of supervision ranges from close to moderate based upon demonstrated skill and performance levels as defined for the position. This position is part of a two-level career path with progression opportunities described in the Core Service Career Path/Succession Planning Guidelines

Requirements

GED/HS Diploma and 6+ months’ experience or equivalent combination of education and experience
Intermediate knowledge of MS Office/Word, Excel, and Outlook and aptitude for new programs.
Experience with Windows based database programs is also required.
Demonstrated ability to appear for work on time, follow directions from a supervisor, interact well with co-workers, understand and follow work rules and procedures, comply with corporate policies, goals and objectives, accept constructive criticism, establish goals and objectives, and exhibit initiative and commitment.
Demonstrated ability to meet or exceed the competencies as listed.
Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions.
Ability to deal with problems involving a few concrete variables in standardized situations.
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Ability to read and comprehend simple instructions, short correspondence, and memos.
Ability to write simple correspondence.
. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written).
One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.

Responsibilities

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.
Use task route function, SalesForce.com, and other processes and tools applicable to escalate issues, request follow-up action, or obtain assistance from other areas of the organization as necessary.
Educate external customers about MedImpact’s roles and responsibilities.
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 appropriately with callers 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 processes and established procedures and guidelines.
Support the department strategy by delivering Customer Service Excellence through telephone courtesy, prompt response to callers, anticipation of customer needs and concerns, solution-oriented problem solving, and adherence to call center scripts, greetings, and call closing messages.
Identify opportunities and make recommendations to department leadership for improvement of workflow processes, operating systems, training programs, reference materials, and quality initiatives that enhance customer experience.
Keep current on new plan information and instructions by attending and participating in staff meetings, company-required training programs, and other activities that develop skills, build teamwork, and provide updated information.
Pharmacy Technician Certified CSR’s support physician calls and can review Prior Authorization (PA) guidelines noted in the MedAccess system.
Be available to answer calls during periods of high volume.
Serve as a resource to the Customer Service team.
Other duties as assigned.