Customer Service Representative III

MedImpact Healthcare Systems•San Diego, CA

10d•$18 - $28•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 The Customer Service Representative III 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 and 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. The Customer Service Representative III role is not included in the CSR progression process.

Requirements

GED/HS Diploma and 2+ years' 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.
Composure
Decision Quality
Organizational Agility
Problem Solving
Customer Focus
Drive for Results
Peer Relations
Time Management
Dealing with Ambiguity
Learning on the Fly
Political Savvy

Responsibilities

Assist with analysis or daily operations of the department including running reports and identifying trends.
Maintain and monitor department quality and productivity.
Be available to answer calls during periods of high volume and serve as a resource to the Customer Service team.
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.
Serve as a resource or Subject Matter Expert (SME) for other team members.
Promptly responds to first level call escalations and determining the appropriate actions to resolve customer issues.
Responsible for coaching, mentoring, and training CSRs as directed by management.
Communicates with both internal and external customers and management to resolve problems and expedite work.
Review and provide operational guidance via the internal help desk to customer service staff.
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.
Keep records of customer interactions and transactions, recording details of inquiries, complaints and comments, as well as actions taken.
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.