Patient Care Representative
About The Position
The responsibility of a Patient Care Representative is to communicate with healthcare professionals to obtain prescription information, with patients to determine and coordinate individual prescription needs, and with team members to resolve issues relating to patient orders. Provide exceptional customer service in an onsite Call Center environment by analyzing situations, navigating multiple computer systems simultaneously, and applying conflict resolution skills to address member needs effectively. Respond to member inquiries regarding plan benefits, offering accurate information and personalized solutions by maintaining organized resources and referring to community services when appropriate. Ensure member privacy and data security by strictly adhering to HIPAA guidelines and company confidentiality policies. Provide accurate information in a professional manner using technology and software to document calls from members, providers, and other customers in a clear and concise manner. Work collaboratively and relay information to appropriate departments and partners using approved company channels and procedures. Perform outreach to physicians, hospitals, pharmacies, and other providers when necessary to answer questions and obtain or provide information. Review, update and become familiar with new and revised benefits, policy information, and/or claim processing procedures. Meet department standards and expectations including but not limited to quality, production, and attendance. Communicate complex information clearly and concisely, tailoring explanations to ensure member understanding. Demonstrate strong active listening and empathy by asking thoughtful questions, addressing concerns, and ensuring members feel heard and supported. Additional duties as assigned.
Requirements
- General PC knowledge including Microsoft Office
- Excellent Customer Service, communication, organizational and interpersonal skills.
- Attention to detail, accurate reporting and follow-up.
- Analytical and problem-solving skills.
- Proficiency in processing and entering prescriptions.
- Ability to work in teams and coordinate efforts to ensure timely completion of work assignments.
- Must be able to sit for extended periods and use a computer for a significant portion of the day.
- Must be able to communicate effectively in person, over the phone, and via email with clients and internal teams.
- Regular use of hands for keyboarding, phone calls, and handling paperwork.
- Must have the ability to read printed and digital materials and hear and comprehend conversations and discussions clearly.
Responsibilities
- Communicate with healthcare professionals to obtain prescription information.
- Communicate with patients to determine and coordinate individual prescription needs.
- Communicate with team members to resolve issues relating to patient orders.
- Provide exceptional customer service in an onsite Call Center environment.
- Analyze situations, navigate multiple computer systems simultaneously, and apply conflict resolution skills to address member needs effectively.
- Respond to member inquiries regarding plan benefits, offering accurate information and personalized solutions.
- Maintain organized resources and refer to community services when appropriate.
- Ensure member privacy and data security by strictly adhering to HIPAA guidelines and company confidentiality policies.
- Provide accurate information in a professional manner using technology and software to document calls from members, providers, and other customers in a clear and concise manner.
- Work collaboratively and relay information to appropriate departments and partners using approved company channels and procedures.
- Perform outreach to physicians, hospitals, pharmacies, and other providers when necessary to answer questions and obtain or provide information.
- Review, update and become familiar with new and revised benefits, policy information, and/or claim processing procedures.
- Meet department standards and expectations including but not limited to quality, production, and attendance.
- Communicate complex information clearly and concisely, tailoring explanations to ensure member understanding.
- Demonstrate strong active listening and empathy by asking thoughtful questions, addressing concerns, and ensuring members feel heard and supported.
- Perform additional duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
