Call Center Member Services Representative
Benecardpbf, Florida, NY, United States
Call Center Member Services Representative
Full Time Florida, Bonita Springs, FL, US
8 days ago Requisition ID: 2217
The Call Center Member Services Representative provides high‑quality customer support to members, pharmacies, and providers in a Pharmacy Benefit Management (PBM) environment. This role is the first point of contact for benefit inquiries, claims questions, and pharmacy support. Representatives deliver accurate, empathetic service while navigating multiple systems and documenting interactions in real time.
This position is ideal for individuals who thrive in a fast‑paced contact center, value teamwork, and take pride in delivering excellent customer experiences. Comprehensive paid training is provided.
Flexible Work Hours:
8:30am-5:00pm
12:30pm-9:00pm
1:30pm-10pm
3:00pm-11:30pm
Key Responsibilities
Customer & Member Support
Handle inbound and outbound calls from members, pharmacies, and authorized representatives
Explain pharmacy benefits, claims status, coverage, formularies, and prior authorizations
Resolving issues professionally while maintaining empathy and clear communication
De‑escalate challenging situations and focus on first‑call resolution
Systems & Documentation
Accurately document call details in real time
Use call center and internal platforms (e.g., RingCentral, SharePoint, ticketing systems)
Submit service or system issues as needed
Quality & Compliance
Meet performance metrics for quality, productivity, attendance, and customer satisfaction
Maintain compliance with HIPAA, PBM policies, and data privacy standards
Apply coaching feedback to continuously improve performance
Work closely with supervisors and teammates to resolve member concerns
Share insights that help improve workflows and member experience
Stay current on plan updates, system changes, and internal communications
Qualifications
Required
High School Diploma or equivalent is required
Excellent skills with dual monitors and multiple applications are required
Proficiency in Microsoft Outlook, Word, and Excel is required
Ability to research and resolve benefit or pharmacy issues during live calls is required
Strong customer service and communication skills are required
High attention to detail and commitment to accuracy is required
Reliable attendance and schedule adherence is required
Preferred
Contact center or call center experience
PBM, pharmacy, or healthcare experience
Familiarity with claims, formulary, or prior authorization processes
Why Join Us
Paid 10–12 week training program
Supportive, team‑oriented contact center environment
Opportunities for growth within a stable PBM organization
Meaningful work that directly supports member health and care access
#J-18808-Ljbffr
Full Time Florida, Bonita Springs, FL, US
8 days ago Requisition ID: 2217
The Call Center Member Services Representative provides high‑quality customer support to members, pharmacies, and providers in a Pharmacy Benefit Management (PBM) environment. This role is the first point of contact for benefit inquiries, claims questions, and pharmacy support. Representatives deliver accurate, empathetic service while navigating multiple systems and documenting interactions in real time.
This position is ideal for individuals who thrive in a fast‑paced contact center, value teamwork, and take pride in delivering excellent customer experiences. Comprehensive paid training is provided.
Flexible Work Hours:
8:30am-5:00pm
12:30pm-9:00pm
1:30pm-10pm
3:00pm-11:30pm
Key Responsibilities
Customer & Member Support
Handle inbound and outbound calls from members, pharmacies, and authorized representatives
Explain pharmacy benefits, claims status, coverage, formularies, and prior authorizations
Resolving issues professionally while maintaining empathy and clear communication
De‑escalate challenging situations and focus on first‑call resolution
Systems & Documentation
Accurately document call details in real time
Use call center and internal platforms (e.g., RingCentral, SharePoint, ticketing systems)
Submit service or system issues as needed
Quality & Compliance
Meet performance metrics for quality, productivity, attendance, and customer satisfaction
Maintain compliance with HIPAA, PBM policies, and data privacy standards
Apply coaching feedback to continuously improve performance
Work closely with supervisors and teammates to resolve member concerns
Share insights that help improve workflows and member experience
Stay current on plan updates, system changes, and internal communications
Qualifications
Required
High School Diploma or equivalent is required
Excellent skills with dual monitors and multiple applications are required
Proficiency in Microsoft Outlook, Word, and Excel is required
Ability to research and resolve benefit or pharmacy issues during live calls is required
Strong customer service and communication skills are required
High attention to detail and commitment to accuracy is required
Reliable attendance and schedule adherence is required
Preferred
Contact center or call center experience
PBM, pharmacy, or healthcare experience
Familiarity with claims, formulary, or prior authorization processes
Why Join Us
Paid 10–12 week training program
Supportive, team‑oriented contact center environment
Opportunities for growth within a stable PBM organization
Meaningful work that directly supports member health and care access
#J-18808-Ljbffr