PBM Customer Service Representative

JOB SUMMARY

The ideal candidate will have exceptional customer service skills, excellent communication skills, and work well on a team. Must also possess the ability to work independently while multi-tasking and prioritizing issues as they arise. The Customer Service Representative will take calls from pharmacies, members and clients and will provide accurate information or support by accessing claims systems and benefit designs. The CSR will also troubleshoot pharmacy claims submissions and document all calls and will respond to routine inquiries on multiple products.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Answering or making calls to clients to learn about and address their needs, complaints, or other issues with products or services.
• Responding efficiently and accurately to callers, explaining possible solutions, and ensuring that clients feel supported and valued.
• Engaging in active listening with callers, confirming or clarifying information and diffusing angry clients, as needed.
• Building lasting relationships with clients and other call center team members based on trust and reliability.
• Utilizing software, databases, scripts, and tools appropriately.
• Understanding and striving to meet or exceed call center metrics while providing excellent consistent customer service.
• Making sales or recommendations for products or services that may better suit client needs.
• Taking part in training and other learning opportunities to expand knowledge of company and position.
• Adhering to all company policies and procedures.
• Respond to incoming calls from our customers on issues related to benefit eligibility questions and prescription status inquiries.
• Guide and educate callers on their prescription benefits, use of plan, formulary, premiums and status of orders and claims or inquiries.
• Ask appropriate questions and listen actively while documenting required information in computer systems.

KNOWLEDGE, SKILLS, & ABILITIES (KSA)

• High School Diploma or equivalent.
• Customer Service or inbound call center experience.
• Experience with a PBM or health insurance company preferred.
• Exceptional customer service, active listening, and verbal and written communication skills, professional phone voice.
• Understanding of company products, services, and policies.
• Proficiency with computers, especially with PBM software, and strong typing skills.
• Ability to ask prying questions and diffuse tense situations.
• Strong time management and decision-making skills.
• Adaptability and accountability.
• Proficient in Microsoft Office and industry related software programs.
• Effective verbal and written communication skills.
• Ability to independently identify, research and resolve issues.
• An intelligent and articulate individual who can relate to people at all levels of an organization and possesses excellent communication skills.

TO ALL RECRUITMENT AGENCIES: The Company and its affiliates do not accept unsolicited agency resumes. Please do not forward resumes for any of our job postings, to our careers sites, or to any employees of the Company or its affiliates. We are not responsible for any fees related to unsolicited resumes.