Customer Service Representative I

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

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!

The Scoop:

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. 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.

What You Get To Do: 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 & tools as 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 with callers as appropriate 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 SMART 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 the customer experience
• 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
• Pharmacy Technician Certified CSR's support physician calls and can review Prior Authorization (PA) guidelines noted in the MedAccess system

Education and/or Experience

For consideration candidates will need

• An Associate's degree (A.A.) or equivalent from two-year College or technical school
• Six (6) months to one (1) year related experience and/or training; or equivalent combination of education and experience
• One (1) to two (2) years of call center customer service experience in a PBM or Healthcare preferred

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.

Travel

This position does not require travel, however attendance maybe required at various local training sessions and/or meetings.

The Perks:

• Medical / Dental / Vision / Wellness Programs
• Paid Time Off / Company Paid Holidays
• 401K with Company match
• Life and Disability Insurance
• Tuition Reimbursement
• Employee Referral Bonus

This position is eligible for Employee Referral Bonus at Level I

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers

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.