Member Services Rep

Job Description

Job Description

Member Service Representative (Pharmacy)

Position Summary

The Member Service Representative (Pharmacy) serves as a key point of contact for pharmacies, patients, clients, and healthcare partners, providing timely, accurate, and compassionate support across a variety of communication channels. This role is responsible for handling high-volume inquiries, supporting prior authorization-related calls, explaining pharmacy benefit information, documenting interactions, and ensuring questions and concerns are efficiently resolved or escalated to the appropriate team.

Shift

• Monday - Friday (11:00am-7:00pm), occasional rotating weekend shift

Responsibilities

• Receives calls from pharmacies, clients, and patients and provides the requested information or support
• Provides clinical call support for prior authorization-related calls and documents in the ticketing system
• Understanding of benefit plans and how to access the plan information, as well as how to communicate this information to patients accurately
• Escalates incoming calls when needed to the appropriate party for resolution
• Demonstrate OMNI channel experience across multiple communication platforms, including phone, email, chat, and other digital channels, ensuring a seamless and consistent service experience.

Required Skills & Qualifications

• High School Diploma or GED required.
• Required: Experience making and/or handling high-volume calls in a call center (healthcare), pharmacy, PBM, managed care, or healthcare setting.
• Ability to communicate pharmacy, healthcare, and benefit information clearly, accurately, and professionally.
• Proficiency with Microsoft Office Suite , including Outlook, Excel, Word, and Teams.
• Strong computer and system-navigation skills with the ability to work across multiple applications simultaneously.
• Ability to effectively multitask in a high-volume, fast-paced environment while maintaining accuracy and focus on the member.

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.

\nCompany Description

Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.

Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?

Company Description

Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.\r\n\r\nOur commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?