Patient Care Representative

Patient Care Representative

The responsibility of a Patient Care Representative is to communicate with healthcare professionals to obtain prescription information, with patients to determine and coordinate individual prescription needs, and with team members to resolve issues relating to patient orders.

Provide exceptional customer service in an onsite Call Center environment by analyzing situations, navigating multiple computer systems simultaneously, and applying conflict resolution skills to address member needs effectively.

Respond to member inquiries regarding plan benefits, offering accurate information and personalized solutions by maintaining organized resources and referring to community services when appropriate.

Ensure member privacy and data security by strictly adhering to HIPAA guidelines and company confidentiality policies.

Provide accurate information in a professional manner using technology and software to document calls from members, providers, and other customers in a clear and concise manner.

Work collaboratively and relay information to appropriate departments and partners using approved company channels and procedures. Perform outreach to physicians, hospitals, pharmacies, and other providers when necessary to answer questions and obtain or provide information.

Review, update and become familiar with new and revised benefits, policy information, and/or claim processing procedures.

Meet department standards and expectations including but not limited to quality, production, and attendance.

Communicate complex information clearly and concisely, tailoring explanations to ensure member understanding.

Demonstrate strong active listening and empathy by asking thoughtful questions, addressing concerns, and ensuring members feel heard and supported.

Additional duties as assigned.

Requirements

General PC knowledge including Microsoft Office

Excellent Customer Service, communication, organizational and interpersonal skills.

Attention to detail, accurate reporting and follow-up.

Analytical and problem-solving skills.

Proficiency in processing and entering prescriptions.

Ability to work in teams and coordinate efforts to ensure timely completion of work assignments.

Working Conditions & Physical Requirements:

This job operates in a call center environment regularly using computers and phones.

Primarily sedentary work; must be able to sit for extended periods and use a computer for a significant portion of the day.

Must be able to communicate effectively in person, over the phone, and via email with clients and internal teams.

Regular use of hands for keyboarding, phone calls, and handling paperwork.

Must have the ability to read printed and digital materials and hear and comprehend conversations and discussions clearly.

About OneVeracity

OneVeracity partners with brokers to help self-funded employers reduce medical and pharmacy costs without compromising care. It delivers Health Plan Solutions, VeracityRx, Care Solutions, and Onsite Health Centers in one integrated model that gives employers a clearer, more coordinated way to manage healthcare spend. The approach is grounded in three guiding principles: enhance care, reduce costs, and make it easy. Founded in 2019 and headquartered in Kennesaw, Georgia, OneVeracity is a privately held company that serves self-funded employers across industries including manufacturing, government, and professional services.

Veracity Benefits, LLC