Specialty Customer Service Representative

Exemption Status:
United States of America (Non-Exempt) $16.47 - $20.80 - $25.13 “Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

This position is not eligible for Sponsorship.

Provides outstanding customer service to pharmacies, physicians, health plan sponsors, and their members, beneficiaries, or employees by responding to and resolving phone inquiries and fax referrals related to specialty benefit information, formulary management, eligibility verification, prior authorization, and other PBM processes.

• Convey a positive image of the company by promptly responding to customer phone inquiries, faxes, and emails 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, and Schedule Adherence.
• Meet required turnaround times for processing incoming faxes and forwarding on to the appropriate Specialty Pharmacy Fulfillment Partner (SPFP).
• Utilize the Specialty Service Center application to provide necessary information to specialty pharmacies in addition to the referral form, in order to expedite the fulfillment process for MID Specialty client members.
• Utilize multiple company database programs to research and resolve complex issues relating to benefit information, formulary compliance, eligibility verification, prior authorization, and other PBM processes.
• Provide information to MID Specialty clients, members, pharmacies and physicians about benefit plan restrictions, member eligibility, prior authorization requirements, and other PBM functions as specified by health plan sponsors.
• Follow up with callers (clients, members, pharmacies and physician provider offices) as appropriate to ensure customer satisfaction and timely response to requests.
• Diffuse irate or emotionally upset customers by actively listening to issues, calming the customer, and providing positive solutions to resolve concerns.
• Represent Med Impact in a positive manner by adhering to established procedures and guidelines.
• Support the corporate strategy by delivering Flawless Fundamentals through telephone courtesy, prompt response to callers, anticipation of customer needs and concerns, solution-oriented problem solving, and adherence to scripts, greetings, and call closing messages when applicable.
• 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, company-required training programs, and other activities that develop skills, build teamwork, and provide updated information.

No supervisory responsibilities.

• This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written).
• One must be able to; manage difficult or emotional client situations;
  Respond promptly to client needs;
  Solicit client feedback to improve service;
  Respond to requests for service and assistance from clients;
  Meet commitments to clients.

• To…