Job Description

Responsible to provide a customer service by telephone of incoming and outbound calls to providers, beneficiaries and pharmacies.

Responsibilities:
• Answer incoming pharmacy calls regarding issues related to a claim transaction, reimbursement, payment, and other required information in accordance with Company Help Desk Call Center performance metrics.
• Answer incoming providers and beneficiaries’ calls following Call Center scripts, in a timely matter and in accordance with call center performance metrics.
• Answer incoming calls and perform outbound calls according to HIPAA and Pharmacy Laws Standards.
• Identify pharmacies, providers and beneficiaries needs, clarify information, research every issue and providing solutions.
• Document all inquiries in the Customer Service Management Applications such as, Service Desk, OneArk and email.
• Route the case to the corresponding internal department or the appropriate Health Insurance Carrier.
• Gu...

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