Customer Care Associate

Customer Care Associate

This position is a front line service position providing assistance members and providers regarding programs, policies, and procedures. Responsibilities include answering incoming calls related to eligibility, benefits, claims and authorization of services from members or providers. Responsibilities also include the administration of intake documentation into the appropriate systems. Overall expectations is to provide outstanding service to internal and external customers and strive to resolve member and provider needs on the first call. Performance expectations are to meet or exceed operations production and quality standards.

Essential Functions:

• Actively listens and probes callers in a professionally and timely manner to determine purpose of the calls.
• Researches and articulately communicates information regarding member eligibility, benefits, EAP services, claim status, and authorization inquiries to callers while maintaining confidentiality.
• Resolves customer administrative concerns as the first line of contact - this may include claim resolutions and other expressions of dissatisfaction.
• Assist efforts to continuously improve by assuming responsibility for identifying and bringing to the attention of responsible entities operations problems and/or inefficiencies.
• Thoroughly documents customers Comments/information and forwards required information to the appropriate staff.

Qualifications

• Registered with FL State Board of Pharmacy
• Proficient typist (avg. 35+ WPM) with strong written and verbal communication skills.
• Able to maneuver through various computer platforms while verifying information on all calls.
• Able to talk and type simultaneously.
• Flexible in scheduling and comfortable with change - customer service is an ever-changing environment.
• Responsible for meeting call handling requirements and daily telephone standards as set forth by management.
• Agree to observing service for the purpose of training and quality control.