Patient Care Advocate
Handle customer service inquiries from members, providers, physicians and internal and external clients related to pharmacy benefits. Work to research and resolve problems in a timely manner. Assist members in understanding and maximizing the use of their pharmacy distribution program. Use computerized system to gather information and respond to questions. Document issues and resolutions in a common database. Escalate issues as necessary.
Handle inbound and outbound member, provider and physician calls. Answer questions related to pharmacy benefits, while maintaining productivity standards and performance guarantees where applicable.
Work with other operational departments to research and resolve mail order and claims issues and respond to members within performance agreement guidelines.
Maintain accurate and complete documentation of all inquiries in order to continuously improve the customer service process and reduce potential legal concerns.
Identify and escalate in a prudent manner, concerns received from patients and/or clients so that corrective action can be pursued and expedited to take care of their needs.
Other duties as needed.
Responsible for good housekeeping techniques, adhering to quality and production standards while complying with all applicable company, state and federal safety and environmental programs and procedures.
- High school diploma or equivalent.
- Minimum 1 year experience in a customer service setting, preferably in a call center environment.
- Excellent phone presentation skills and communication skills.
- Demonstrated ability to handle challenging customers in a professional manner.
- Ability to adapt in a dynamic work environment, learn quickly, solve problems and make decisions.
- General PC knowledge including Microsoft Office and Internet.
- Willingness to work a flexible schedule for peak call times.