Customer Service Representative I
MedImpact Healthcare Systems, Inc., Tempe, Arizona, us, 85285
### Exemption Status:United States of America (Non-Exempt)### $16.47 - $20.80 - $25.13“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.
A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”This position is not eligible for Sponsorship.MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!# **Job Description****Summary**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 & 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.
This position is part of a two-level career path with progression opportunities described in the Core Service Career Path/Succession Planning Guidelines**Essential Duties and Responsibilities** include the following. Other duties may be assigned.* 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.* Deliver service that meets or exceeds department performance standards for Average Hold Time, Abandonment Rate, Talk Time, Quality, Adherence, and One-touch Resolution.* Utilize multiple company database programs to research and resolve complex issues relating to benefit information, claims adjudication, eligibility verification, prior authorization, and other PBM processes.
Use task route function, SalesForce.com, and other processes and tools applicable to escalate issues, request follow-up action, or obtain assistance from other areas of the organization as necessary.* Educate external customers about MedImpact’s roles and responsibilities.
Provide information about override guidelines, benefit plan restrictions, prior authorization requirements, grievance and appeal processes, and other PBM functions as specified by health plan sponsors in online CS Notes.* Follow up appropriately with callers to ensure customer satisfaction and timely response to requests. Diffuse irate or emotionally upset customers by appropriately listening to issues, calming the customer, and providing positive solutions to resolve concerns.* Represent MedImpact in a positive manner by adhering to processes and established procedures and guidelines. Support the department strategy by delivering Customer Service Excellence through telephone courtesy, prompt response to callers, anticipation of customer needs and concerns, solution-oriented problem solving, and adherence to call center scripts, greetings, and call closing messages.* Identify opportunities and make recommendations to department leadership for improvement of workflow processes, operating systems, training programs, reference materials, and quality initiatives that enhance customer experience.* Keep current on new plan information and instructions by attending and participating in staff meetings, company-required training programs, and other activities that develop skills, build teamwork, and provide updated information.* Pharmacy Technician Certified CSR’s support physician calls and can review Prior Authorization (PA) guidelines noted in the MedAccess system.* Be available to answer calls during periods of high volume.* Serve as a resource to the Customer Service team.* Other duties as assigned.**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 6+ months’ 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.**Certificates, Licenses, Registrations**None 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:ComposureDecision QualityOrganizational AgilityProblem SolvingCustomer FocusDrive for ResultsPeer RelationsTime ManagementDealing with AmbiguityLearning on the FlyPolitical 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 #J-18808-Ljbffr
A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”This position is not eligible for Sponsorship.MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!# **Job Description****Summary**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 & 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.
This position is part of a two-level career path with progression opportunities described in the Core Service Career Path/Succession Planning Guidelines**Essential Duties and Responsibilities** include the following. Other duties may be assigned.* 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.* Deliver service that meets or exceeds department performance standards for Average Hold Time, Abandonment Rate, Talk Time, Quality, Adherence, and One-touch Resolution.* Utilize multiple company database programs to research and resolve complex issues relating to benefit information, claims adjudication, eligibility verification, prior authorization, and other PBM processes.
Use task route function, SalesForce.com, and other processes and tools applicable to escalate issues, request follow-up action, or obtain assistance from other areas of the organization as necessary.* Educate external customers about MedImpact’s roles and responsibilities.
Provide information about override guidelines, benefit plan restrictions, prior authorization requirements, grievance and appeal processes, and other PBM functions as specified by health plan sponsors in online CS Notes.* Follow up appropriately with callers to ensure customer satisfaction and timely response to requests. Diffuse irate or emotionally upset customers by appropriately listening to issues, calming the customer, and providing positive solutions to resolve concerns.* Represent MedImpact in a positive manner by adhering to processes and established procedures and guidelines. Support the department strategy by delivering Customer Service Excellence through telephone courtesy, prompt response to callers, anticipation of customer needs and concerns, solution-oriented problem solving, and adherence to call center scripts, greetings, and call closing messages.* Identify opportunities and make recommendations to department leadership for improvement of workflow processes, operating systems, training programs, reference materials, and quality initiatives that enhance customer experience.* Keep current on new plan information and instructions by attending and participating in staff meetings, company-required training programs, and other activities that develop skills, build teamwork, and provide updated information.* Pharmacy Technician Certified CSR’s support physician calls and can review Prior Authorization (PA) guidelines noted in the MedAccess system.* Be available to answer calls during periods of high volume.* Serve as a resource to the Customer Service team.* Other duties as assigned.**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 6+ months’ 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.**Certificates, Licenses, Registrations**None 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:ComposureDecision QualityOrganizational AgilityProblem SolvingCustomer FocusDrive for ResultsPeer RelationsTime ManagementDealing with AmbiguityLearning on the FlyPolitical 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 #J-18808-Ljbffr