Pharmacy Customer Service Representative
About The Position
We're seeking compassionate and detail-oriented Pharmacy Customer Service Representatives to support Medicare members with prescription drug coverage and pharmacy benefit questions. This is a high-volume, customer-focused role where you'll assist members, providers, pharmacies, brokers, and internal teams with pharmacy-related inquiries and issue resolution. Many calls involve members who are experiencing barriers to accessing medications, making it essential to listen carefully, research solutions, explain benefits clearly, and guide callers through the appropriate next steps. Representatives must be comfortable handling sensitive situations with empathy, professionalism, and a strong commitment to customer service.
Requirements
- High School Diploma or GED.
- Previous customer service or call center experience.
- Strong verbal and written communication skills.
- Ability to explain complex information clearly and professionally.
- Strong attention to detail and accuracy.
- Comfortable navigating multiple systems while assisting callers.
- Ability to work independently and collaboratively in a team environment.
- Reliable attendance and commitment to a performance-driven work environment.
Nice To Haves
- Pharmacy Technician experience strongly preferred.
- Medicare, Medicare Part D, pharmacy benefits, PBM, or prescription coverage experience.
- Healthcare, insurance, benefits, claims, prior authorization, or member services experience.
Responsibilities
- Respond to inbound calls regarding Medicare pharmacy benefits, prescription coverage, pharmacy claims, and plan information.
- Assist members, providers, pharmacies, brokers, and internal teams with pharmacy-related questions and issue resolution.
- Research and resolve inquiries using internal systems, vendor applications, plan documents, and knowledge resources.
- Review and interpret pharmacy benefit information, policies, and coverage requirements to provide accurate guidance.
- Document all customer interactions accurately and thoroughly.
- Escalate complex issues and coordinate with internal teams or vendors as needed.
- Maintain compliance with HIPAA, Medicare, and organizational policies.
- Meet quality, productivity, schedule adherence, and customer satisfaction goals.
- Participate in ongoing training and coaching to stay current on pharmacy benefits, Medicare programs, and internal processes.
Benefits
- Medical, dental & vision
- Critical Illness, Accident, and Hospital
- 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
- Life Insurance (Voluntary Life & AD&D for the employee and dependents)
- Short and long-term disability
- Health Spending Account (HSA)
- Transportation benefits
- Employee Assistance Program
- Time Off/Leave (PTO, Vacation or Sick Leave)
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
