Job Description
Job Description
Job Description/Responsibilities:
- Determine pharmacy eligibility by reviewing, researching, and analyzing information in the appropriate system
- Maintain and enter member/prescription information into systems as information is received and forward records to the appropriate parties when applicable.
- Record and respond to calls/emails/faxes from Member, Providers, and Pharmacies.
- Maintain a high level of knowledge to answer specific Pharmacy Plan Benefit information or sharing guideline related questions.
- Provide exceptional customer service for incoming/outgoing calls.
- Provide timely and thorough responses to internal and external customers.
- Maintain HIPAA/PHI guidelines to ensure the confidentiality of all calls and documents.
- Escalate difficult issues to the appropriate party.
- Use critical thinking and reasoning to resolve conflicts and manage workloads efficiently.
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- Working in call center (95% inbound calls, 5% outbound calls) off phone queue
- About 30-50 calls/day, average call handle time is 6.5 minutes
- Calls will be from pharmacies, clients, members, other insurance providers
- Calling to get missing information, prescription updates
- Lots of people call about their pharmacy coupon cards
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.
Company DescriptionHere 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?