This is a temp-to-perm position.
This is the primary service-level position in a business to business multimedia PBM contact center. The Member Services Rep serves as an initial point of contact to clients, nurses, pharmacies and physicians for inbound and outbound calls, faxes, e-mails, files and orders. The MSR also handles multimedia contacts from nurses authorizing payment for medications for hospice patients which must be entered into a web-based database within required turnaround times. Accuracy and knowledge of various operating procedures for different customers is a must. Additionally, customer service receives multimedia contacts from retail and long term care pharmacies requiring claims processing assistance, reimbursement disputes, and contract requests. Representatives must review all claim data and authorizations on file to resolve rejection issues.
Excellent customer service skills are a must in all interactions with hospice clients and pharmacy partners.
• Knowledge of proper telephone etiquette; previous call center experience preferred.
• Must have attention to detail with excellent problem solving and multi-tasking skills
• Computer literacy / data entry skills are required and proficiency in Microsoft Word, Outlook, and Excel
• Experience with image display software and web-based data entry software.
• Knowledge of Medical Terminology and ICD-10 Codes preferred.
• Knowledge of drug therapies. (Generic/Brand names, drug classes, sigs)
• Need to be able to work a flexible schedule including nights and weekends.
Education and Experience
• Previous pharmacy technician experience highly desired, certification or licensure highly desired and/or related PBM business experience with knowledge of long term care pharmacy billing.
• Must have a High School diploma or equivalent. College or technical training a plus.
Training is 3 weeks from 8am- 5pm after training
Shift will be 8 hours between 12:00pm-11:00pm