Customer Service Representative

Pay rate:$18/Hr

Job Overview

The role focuses on making outbound calls to patients and healthcare providers to resolve pharmacy order-related issues, including delivery arrangements, payment concerns, missing clinical information, and required patient consultations. The ideal candidate will have strong communication skills, a customer-focused approach, and the ability to resolve inquiries accurately and efficiently.

Key Responsibilities

• Make outbound calls to patients and healthcare providers to resolve pharmacy order issues and provide updates.
• Perform back-office administrative tasks related to pharmacy orders, documentation, and issue resolution.
• Deliver excellent customer service while handling routine inquiries and escalated calls professionally.
• Address issues related to medication delivery arrangements, payments, clinical information requirements, and required consultations.
• Maintain a working knowledge of health plan benefits, provider networks, applicable CMS regulations, and healthcare partner policies.
• Review and update customer information, document interactions, and maintain accurate records in relevant systems.
• Use sound judgment to prioritize tasks, investigate concerns, and implement appropriate resolutions.
• Follow established procedures, quality standards, privacy requirements, and compliance guidelines.
• Collaborate with internal teams and healthcare providers to ensure timely resolution of outstanding issues.
• Perform other related duties as assigned.

Required Qualifications

• High school diploma or GED equivalent; higher education is acceptable.

• At least 2 years of combined or related experience in healthcare, call center operations, or customer service.

• Experience using a telephone and computer as primary tools for performing job responsibilities.

• Ability to work variable shifts supporting operational hours from 7:00 AM to 7:00 PM CT, Monday through Friday.

• Proficiency in Microsoft Office applications, including:

• Microsoft Word: Creating and maintaining documents.

• Microsoft Excel: Creating and maintaining spreadsheets.

• Microsoft Outlook: Managing email communications and calendars.

• Strong verbal and written communication skills.

• Excellent problem-solving, multitasking, and organizational abilities.

• Ability to handle sensitive information professionally and maintain confidentiality.

Preferred Qualifications

• Associate degree or higher in healthcare or a related field.
• Knowledge of medical terminology.
• Familiarity with ICD-9, ICD-10, and Eligible to work coding systems.
• Previous experience in pharmacy services, medical billing, health insurance, or healthcare customer support.
• Experience handling patient inquiries, provider communications, and healthcare-related administrative processes.

Remote Work Requirements

• Must have a dedicated home workspace that is separate from common living areas and supports privacy during work activities.
• Must be able to securely handle and protect confidential company, patient, and healthcare-related information.
• Must have access to reliable, high-speed internet that meets the employer's technical requirements.
• Must be able to attend and participate in virtual training sessions from home.
• Must maintain a professional, quiet, and secure work environment throughout working hours.

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