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18 Ssollc Jobs Hiring Near You

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Maine Prevention Network Manager

Augusta, ME · On-site

$51.50K - $70.30K/yr

Maine Prevention Network (MPN) Manager Location: Augusta, ME Work Model: Hybrid (minimum 2 days/week onsite at Maine CDC; per State of Maine Telework Policy) Position Summary Are you passionate about ...

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Young Adult Prevention Coordinator

Augusta, ME · Hybrid

Young Adult Prevention Coordinator Location: Augusta, ME Work Arrangement: Hybrid (Partial Telework) This position allows for partial telework with management approval. A minimum of two (2) days per ...

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Accountant - Wisconsin

Madison, WI · Hybrid

$47 - $75/hr

Accountant - Madison, WI (ROLLING APPLICATION) Pay Range: $47-$75 per hour Work Model: Hybrid or Onsite Location: Madison, WI Application Status: Applications accepted on a rolling basis. Position ...

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Program Support Specialist - Wisconsin

Madison, WI · Hybrid

$18 - $35/hr

Program Support Specialist - Madison, WI (ROLLING APPLICATION) Pay Range: $18-$35 per hour Work Model: Hybrid or Onsite Application Status: Accepting applications on a rolling basis Position Summary ...

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Child Care Eligibility Specialist

Augusta, ME

Child Care Eligibility Specialist (CCES) Location: 2 Anthony Avenue, Augusta, ME Schedule: Monday-Friday | 8:30 AM - 5:00 PM (40 hours/week) Work Model: FullTime, InOffice Position Overview The Child ...

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Nurse - Complex Case Unit

Augusta, ME

Nurse - Complex Case Unit Location: Augusta, ME Position Overview The Nurse supports the Complex Case Unit (CCU) within the Office of MaineCare Services by assisting MaineCare and nonMaineCare ...

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Benefits Specialist - Wisconsin

Madison, WI

$20 - $40/hr

Benefits Specialist - Madison, WI (ROLLING APPLICATION) Pay Range: $20-$40 per hour Work Model: Hybrid or Onsite Application Status: Accepting applications on a rolling basis Location: Madison, WI ...

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Administrative Associate

Augusta, ME

$17.25 - $21.50/hr

Our client is looking for Administrative Specialists to provide highlevel administrative, technical, and customer support to programs serving Maine residents, families, providers, and community ...

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Federal Grants Accountant

Winthrop, ME · Hybrid

Federal Grants Accountant Location: Winthrop, ME Work Model: Onsite with up to 2 remote days/week after 6 months (management approval) Schedule: Fulltime, 40 hours/week, Monday-Friday, between 7:00 ...

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Healthcare Customer Service Representative - Pharmacy Benefits

ssollc

Augusta, ME

$15.75 - $21.50/hr

Other

Medical, Dental, Vision, Retirement, PTO

Posted 26 days ago

Job description

Healthcare Customer Service Representative – Pharmacy Benefits

Location: Augusta, ME

Position Overview

The Healthcare Customer Service Representative – Pharmacy Benefits supports MaineCare members, pharmacies, and healthcare providers by providing customer service, education, and technical assistance related to prescription coverage, Medicare Part D, and MaineCare pharmacy benefits. This role requires strong communication skills, attention to detail, and the ability to apply policies and procedures accurately.

Key Responsibilities

Customer & Member Support

  • Respond to inbound calls from MaineCare members, pharmacists, technicians, and other stakeholders.
  • Educate members on Medicare Part D plans, Medicare Savings Programs, and MaineCare pharmacy benefits.
  • Assist members with enrollment, coverage questions, and benefit explanations.
  • Resolve issues related to copays, deductibles, premiums, medication access, and prescription fills.
  • Support members who are out of medication or unable to fill prescriptions.

Claims & Coverage Support

  • Review insurance coverage for pharmacies, providers, hospitals, and members.
  • Support claims processing activities including evaluation, pricing, and service requests.
  • Apply rules, regulations, policies, and documentation requirements to individual cases.

Administrative & Technical Support

  • Create, edit, and manage correspondence, reports, and informational materials.
  • Develop and maintain computerized forms, graphics, charts, tables, and web content.
  • Examine documents, identify errors or irregularities, and take corrective action as authorized.
  • Perform routine administrative duties including scheduling, coordinating meetings, and responding to inquiries.
  • Track and monitor contracts, licenses, fees, and reports; reconcile funds as required.

Training & Leadership (as assigned)

  • Coordinate and present training, workshops, and orientation sessions.
  • Develop standard work procedures within established guidelines.
  • Provide work direction and support to team members as needed.
  • Confer with supervisors on performance matters when applicable.

Compliance

  • Comply with all State policies, information security standards, and confidentiality requirements.
Minimum Qualifications
  • Training, education, or experience in office or administrative support demonstrating:
    • Proficiency with modern office practices and software
    • Ability to make independent decisions within established procedures
  • Knowledge or ability to learn:
    • Medicare, MaineCare, or healthcare program operations
    • Graphics, publications, and electronic content management
    • Information distribution via the internet and web pages
  • Demonstrated ability to:
    • Prepare business correspondence and standard reports
    • Interpret and apply laws, rules, policies, and procedures
    • Detect errors, analyze information, and resolve problems
    • Present information clearly to individuals and groups
    • Exercise sound judgment and attention to detail
  • Strong customer service, communication, and organizational skills
Benefits (Through SSO)

SSO offers a competitive benefits package, including:

  • Medical, dental, and vision insurance
  • 401(k) with discretionary employer match
  • Paid time off and paid holidays
  • Flexible spending accounts (FSA)
  • Additional employee perks

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