Job: Customer Service Representative - Tucson, AZ
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The Customer Service Representative is responsible for answering incoming calls from customers while ensuring a high level of customer service and maximizing productivity. The responsibilities of this position are providing customer service support to members, customers, and/or providers. Direct phone-based customer interaction to answer and resolve a wide variety of inquiries. Individuals chosen for this position will answer questions related to pharmacy benefits, mail order and pharmacy assistance calls.
Primary Responsibilities:Answers incoming calls; assists customers/pharmacies/physicians with orders and reorders, benefit eligibility questions and prescription status inquiries. Escalates drug related calls to appropriate pharmacist.Assist pharmacies and members on all issues related to processing of pharmacy claims. Determines appropriateness of overriding pharmacy claims edits and error messages.Coordinates internal resolution of claims exceptions and other issues.Makes outbound calls on prescriptions with hold orders and payment issues.May also assist with entering new prescription orders into system.Educates customers on benefits, use of plan, formulary, premiums and status of orders, claims or inquiries.Other duties as assigned.
Skills / Requirements