MedImpact
Customer Service Representative III
The Customer Service Representative III provides outstanding customer service to pharmacies, physicians, health plan sponsors, and their members, beneficiaries, or employees by responding to and resolving phone inquiries related to benefit information, claims adjudication, eligibility verification, prior authorization, and other PBM processes. Works under general supervision, relying upon instructions, work process guidelines, policies and procedures, and company knowledge/experience to perform the functions of the job. The extent of supervision ranges from close to moderate based upon demonstrated skill and performance levels as defined for the position. The Customer Service Representative III role is not included in the CSR progression process. Essential duties and responsibilities include the following. Other duties may be assigned. Assist with analysis or daily operations of the department including running reports and identifying trends. Maintain and monitor department quality and productivity. Be available to answer calls during periods of high volume and serve as a resource to the Customer Service team. Identify opportunities and make recommendations to department leadership for improvement of workflow processes, operating systems, training programs, reference materials, and quality initiatives that enhance the customer experience. Serve as a resource or Subject Matter Expert (SME) for other team members. Promptly responds to first level call escalations and determining the appropriate actions to resolve customer issues. Responsible for coaching, mentoring, and training CSRs as directed by management. Communicates with both internal and external customers and management to resolve problems and expedite work. Review and provide operational guidance via the internal help desk to customer service staff. Convey a positive image of the company by promptly responding to customer phone inquiries and determining the appropriate actions to resolve issues, gather and provide information, and offer assistance. Keep records of customer interactions and transactions, recording details of inquiries, complaints and comments, as well as actions taken. Keep current on new plan information and instructions by attending and participating in staff meetings, RTL's, company-required training programs, and other activities that develop skills, build teamwork, and provide updated information. Supervisory Responsibilities: No supervisory responsibilities Client Responsibilities: This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients. Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience: GED/HS Diploma and 2+ years' experience or equivalent combination of education and experience Computer Skills: Intermediate knowledge of MS Office/Word, Excel, and Outlook and aptitude for new programs. Experience with Windows based database programs is also required. Other Skills and Abilities: Demonstrated ability to appear for work on time, follow directions from a supervisor, interact well with co-workers, understand and follow work rules and procedures, comply with corporate policies, goals and objectives, accept constructive criticism, establish goals and objectives, and exhibit initiative and commitment. Demonstrated ability to meet or exceed the competencies as listed. Reasoning Ability: Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations. Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Mathematical Skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs. Language Skills: Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization. Competencies: To perform the job successfully, an individual should demonstrate the following competencies: Composure, Decision Quality, Organizational Agility, Problem Solving, Customer Focus, Drive for Results, Peer Relations, Time Management, Dealing with Ambiguity, Learning on the Fly, Political Savvy. Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers, light traffic). Work Location: This position must work on-site at the San Diego Headquarters or Tempe office location for purposes of providing adequate support to internal clients; being available for face-to-face interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as for facilitation of quick and effective decisions through collaboration with stakeholders. Remote work is not an option for these purposes. Working Hours: This is a full-time non-exempt position requiring one to be able to work overtime from time to time in order to get the job done. Therefore, one must have the ability to work nights, weekends or on holidays as required. This may be changed at any time to meet the needs of the business. The typical working hours for this position are Monday through Friday from 8:00am to 5:00pm. Travel: This position requires no travel however attendance may be required at various local conferences and meetings. The Perks: Medical / Dental / Vision / Wellness Programs Paid Time Off / Company Paid Holidays Incentive Compensation 401K with Company match Life and Disability Insurance Tuition Reimbursement Employee Referral Bonus MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets. Equal Opportunity Employer, Male/Female/Disabilities/Veterans
OSHA/ADA:
To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Disclaimer:
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.
The Customer Service Representative III provides outstanding customer service to pharmacies, physicians, health plan sponsors, and their members, beneficiaries, or employees by responding to and resolving phone inquiries related to benefit information, claims adjudication, eligibility verification, prior authorization, and other PBM processes. Works under general supervision, relying upon instructions, work process guidelines, policies and procedures, and company knowledge/experience to perform the functions of the job. The extent of supervision ranges from close to moderate based upon demonstrated skill and performance levels as defined for the position. The Customer Service Representative III role is not included in the CSR progression process. Essential duties and responsibilities include the following. Other duties may be assigned. Assist with analysis or daily operations of the department including running reports and identifying trends. Maintain and monitor department quality and productivity. Be available to answer calls during periods of high volume and serve as a resource to the Customer Service team. Identify opportunities and make recommendations to department leadership for improvement of workflow processes, operating systems, training programs, reference materials, and quality initiatives that enhance the customer experience. Serve as a resource or Subject Matter Expert (SME) for other team members. Promptly responds to first level call escalations and determining the appropriate actions to resolve customer issues. Responsible for coaching, mentoring, and training CSRs as directed by management. Communicates with both internal and external customers and management to resolve problems and expedite work. Review and provide operational guidance via the internal help desk to customer service staff. Convey a positive image of the company by promptly responding to customer phone inquiries and determining the appropriate actions to resolve issues, gather and provide information, and offer assistance. Keep records of customer interactions and transactions, recording details of inquiries, complaints and comments, as well as actions taken. Keep current on new plan information and instructions by attending and participating in staff meetings, RTL's, company-required training programs, and other activities that develop skills, build teamwork, and provide updated information. Supervisory Responsibilities: No supervisory responsibilities Client Responsibilities: This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients. Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience: GED/HS Diploma and 2+ years' experience or equivalent combination of education and experience Computer Skills: Intermediate knowledge of MS Office/Word, Excel, and Outlook and aptitude for new programs. Experience with Windows based database programs is also required. Other Skills and Abilities: Demonstrated ability to appear for work on time, follow directions from a supervisor, interact well with co-workers, understand and follow work rules and procedures, comply with corporate policies, goals and objectives, accept constructive criticism, establish goals and objectives, and exhibit initiative and commitment. Demonstrated ability to meet or exceed the competencies as listed. Reasoning Ability: Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations. Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Mathematical Skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs. Language Skills: Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization. Competencies: To perform the job successfully, an individual should demonstrate the following competencies: Composure, Decision Quality, Organizational Agility, Problem Solving, Customer Focus, Drive for Results, Peer Relations, Time Management, Dealing with Ambiguity, Learning on the Fly, Political Savvy. Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers, light traffic). Work Location: This position must work on-site at the San Diego Headquarters or Tempe office location for purposes of providing adequate support to internal clients; being available for face-to-face interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as for facilitation of quick and effective decisions through collaboration with stakeholders. Remote work is not an option for these purposes. Working Hours: This is a full-time non-exempt position requiring one to be able to work overtime from time to time in order to get the job done. Therefore, one must have the ability to work nights, weekends or on holidays as required. This may be changed at any time to meet the needs of the business. The typical working hours for this position are Monday through Friday from 8:00am to 5:00pm. Travel: This position requires no travel however attendance may be required at various local conferences and meetings. The Perks: Medical / Dental / Vision / Wellness Programs Paid Time Off / Company Paid Holidays Incentive Compensation 401K with Company match Life and Disability Insurance Tuition Reimbursement Employee Referral Bonus MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets. Equal Opportunity Employer, Male/Female/Disabilities/Veterans
OSHA/ADA:
To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Disclaimer:
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.