Customer Service Representative

Rose International
August 28, 2020
San Antonio, TX
Job Type


Position Title: Sr. Customer Service Rep

Position Number: 345164

Location: San Antonio, TX 78249

Position Type: Temporary

Required Skill Set:

Customer Service, Pharmacy

Position Description:

**C2C is not available**
**Only U.S. Citizens and those authorized to work in the U.S. can be considered as W2 candidates.**
JOB TITLE: Sr. Customer Service Rep
START DATE: 09/07/2020
END DATE: 12/31/2020
HOURS: M-F, 9 am – 6 pm
LOCATION: San Antonio, TX 78249


Job Summary
The customer service representative will make outbound calls to members and physicians to improve medication adherence and other pharmacy related quality metrics. Responsible for gathering prescription refill orders and providing excellent customer service as well as determining the eligibility of members applying for the Medical Assistance Program.

Essential Job Functions
• Conduct a high volume of outbound calls to members to discuss reasons for non-compliant to medication(s), schedule pharmacy telephonic appointments, and/or obtain important follow up information from providers. Outbound calls are made primarily using an autodialer requiring precision to detail and adaptability to type of response needed.
• May answer inbound calls from members and assists them with their inquiries. Routes calls to appropriate department if necessary.
• Follows system scripting and validates member demographic information.
• Documents the provider or member's record with accurate information obtained on the call.
• Provides support to internal staff, subcontractors and providers with respect to Medicare drug related issues.
• Participates in and contributes to the overall pharmacy quality improvement initiatives.
• Collects and maintains eligibility information in an appropriate and confidential manner.
• Enters all assigned applications within a specified time frame in order to ensure eligibility deadlines are met accordingly.
• Exhibits excellent phone and communication skills while providing complete and accurate information to members.
• Requests additional or supplemental information via correspondence in order to complete applications.
• Adheres to assigned schedule and quality metrics.
• Uses a multi-lined telephonic system to answer calls regarding eligibility requirements and medication refill orders.
• Performs all other related duties as assigned.

Minimum Required Education, Experience & Skills
• Minimum of High School Diploma or GED
• Minimum of two years’ experience in a pharmacy setting
• Working knowledge of HIPAA Privacy and Security Rules and CMS security requirements
• General writing skills and ability to produce work free from typographical or spelling errors.
• Working knowledge of Microsoft Office (excel), Internet and e-mail
• Medical terminology knowledge base

Preferred Education, Experience & Skills
• Bilingual
• PBM experience
• Previous auditing experience
• Advanced knowledge of NCPDP and other types of prescription drug claims is required
• Working knowledge of Medicare Part B and Part D coverage guidelines and payment methodologies Previous retail pharmacy experience
• Previous Call Center experience
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