Servicing Representative

Independent Health

127d • $19

About The Position

The Servicing Representative is a customer service professional who displays confidence, a passion for service, and practices empathetic listening towards all Pharmacy Benefit Dimensions (PBD) customers. The Servicing Representative functions as an advocate for all customers and resolves all inquiries (i.e., phone, mail, fax, and email.) They utilize system tools and resources to address and resolve inquiries; provide benefit clarification and eligibility; communicate claim and reimbursement information, facilitate proper utilization of policies and procedures, coordinate resolution to streamline processes; make demographic changes; and educate customers on regulatory policies and procedures.

Requirements

• High School or GED required; Associate degree preferred.
• Six (6) months experience working for a health insurance company, physician’s office, or pharmacy required.
• Experience handling self-funded pharmacy calls preferred.
• Experience in a call center operations environment preferred.
• Demonstrated ability to effectively communicate with internal and external customers.
• Excellent written/verbal communication skills and excellent customer service skills.
• Experience handling high volume, inbound and outbound phone calls preferred.
• Demonstrated ability to listen with intent to understand.
• Demonstrated proficiency to verbally translate written communication.
• Typing 35-40 words a minute required.
• Demonstrated proficiency in problem solving and proven ability to prioritize accordingly.
• PC and Windows experience with proficient typing skills and ability to utilize multiple system tools simultaneously.
• Strong organizational/time management skills.
• Proven examples of displaying the PBD values: Trusted Advisor, Innovative, Excellence, Guardianship, Dedication, and Caring.

Responsibilities

• Act as a customer advocate by providing excellent customer service when answering customer phone calls, written correspondence, and servicing walk-in members in a timely fashion.
• De-escalate customers as needed and resolve customer complaints.
• Ensure that customers obtain accurate and up-to-date information on policies and procedures and communicate a successful resolution to inquiries.
• Ensure compliance with all CMS rules and regulations.
• Log all contacts into appropriate systems.
• Meet or exceed all department standards in quality, productivity, and accuracy goals.
• Maintain technical knowledge regarding Pharmacy Benefit Dimensions’ contracts and benefits.
• Attend required training sessions as needed.
• Provide accurate and up-to-date information to all customers by documenting all pertinent information into appropriate systems.
• Address first level complaints and provide assistance on appeals as needed.
• Receive and effectively resolve written inquiries from members regarding claims, benefits, eligibility, reimbursement, and participating providers.
• Perform other duties as required by immediate supervisor.

Benefits

• Scorecard incentive
• Full range of benefits
• Generous paid time off

What This Job Offers

• Education Level: High school or GED