As the Rx Customer Service Specialist, you will serve at the front line of all incoming and outgoing communication (calls, emails, and fax) with pharmacies, beneficiaries and prescribers. You will use Rx Platform and other resources as necessary to resolve callers needs. Furthermore, you’re the best at it because great customer service is definitely a skill you were born with.
The fundamentals for the job
- You will manage all incoming calls, emails, faxes, and web-generated requests from pharmacies, beneficiaries and prescribers.
- All calls must be managed within the service-level standards set by CMS or by client; 80% of calls should fall within service level, less than 5% abandon rate and speed to
answer should be less than 30 seconds. You got this from the get go.
- Rejection support, including overrides.
- Coverage Determination, exception and appeal status to clients.
- Administrative PAs- Document PA request inquiries, issues, status and resolution in accordance with federal and department / company policies and guidelines.
- Answer questions and recommend corrective services to address customer complaints, payment status, manual reversal requests, benefit/eligibility support, provider
portal support and response to price appeals.
- Member card production, provider directories and conduct client satisfaction surveys.
- Seriously, no one holds a candle to you in this area.
We are a different kind of PBM and a different kind of company. Our entire organization has a culture of accountability, a sense of urgency, and an unstoppable commitment to finding a better way.