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Customer Service Associate - Retail Services (Bilingual -spanish- preferred)

Coordinates and resolves customer service issues with functional area specialists in a timely, efficient, and courteous manner in order to provide a high level of Patient advocacy.
 
Basic Functions:
 
  • Demonstrates appropriate utilization of current telephony systems while receiving inbound calls and initiating outbound calls to and from Pharmacies, Adjustors, NCM’s and Patients for expediting resolutions of blocked transactions/pharmacy bill issues.
  • Determines type of inquiry, resolving or assigning issues to the appropriate functional area (Helpdesk, Support Services, Bill Review Services, Program Recruitment, Assist Line, Customer Relations, Mail Order Services, MS&E Services, etc...) in a timely and accurate manner.
  • Works with network pharmacies and PMSI staff in troubleshooting patient profiles for processing prescription medications for online adjudication or payment resolution.
  • Works with the PMSI Systems (Universe, Online Tools – Carrier Specification and Documentation Resources), while documenting issues and resolving claims relating to Pharmacy, Carrier and Patient.
  • Works with Supervisor to ensure established work schedule is adhered to, and that personal time away is self-managed per departmental expectations.
  • Works with Supervisor to identify needs to strengthen basic metrics in order to be successful in the current role of CSA I.
  • Work with Supervisor to identify career path and establish goals by utilizing the current online tools and training necessary for advancement into other areas of interest.
  • Works with Management on any other special projects assigned.
     
    Job Qualifications:

    Education
  • Required: Associate’s degree or equivalent experience
  • Desired: Associate’s degree in a healthcare field

    Work Hours
  • Mon,Wed,Thur, Fri - 10:30am-7:00pm
  • Sun - 9:00am-5:30pm
  • Tue, Sat - OFF

    Work Experience
  • Required: 2+ years customer service experience
  • Desired:  Prior experience in a call center/customer care environment; 2 years of retail and/or mail order pharmacy experience
     
    Licenses/Certifications:
  • Desired:  Pharmacy Technician or state pharmacy license (within past 5 years)
  • .