Contact Center Representative

4 days ago

San Diego, California, United States MedImpact Full time
Job Description

The Contact Center Specialist plays a vital role in providing research support to multiple internal departments at MedImpact. This position requires strong communication skills to provide direct member support through email requests and partner with Business Solutions on client support teams.

Key Responsibilities:

  • Act as primary escalation point of contact for members, doctors, and pharmacies, deescalating upset callers in an efficient and knowledgeable manner.
  • Responsible for coding claims and claims processing in accordance with company policy and procedures, including regulatory requirements.
  • Respond to inquiries via multiple communication channels, determining the correct course of action for problem resolution.
  • Evaluate and identify claims processing training needs, making recommendations for enhancements.
  • Identify and record concerns, grievances, and error trends to develop weekly communications to the CSR's.
  • Participate in staff meetings, training programs, and other courses to maintain skills needed for this role.
  • Coordinate written notifications to members, physicians, and pharmacies following regulatory guidelines for claims that are missing information.
  • Manage claims inbox, customer service inbox, and ops research inbox, keeping records of customer interactions and transactions.

Requirements:

  • Associate degree or equivalent from a two-year college or technical school.
  • At least two years of related experience and/or training or equivalent combination of education and experience.
  • Previous healthcare or PBM experience with knowledge of medical and pharmacy terminology.
  • Intermediate knowledge of MS Office/Word, Excel, and Outlook, and aptitude for new programs.
  • Current Pharmacy Technician License or National CPhT certification without restriction preferred.

Perks:

  • Medical, dental, vision, and wellness programs.
  • Paid time off and company-paid holidays.
  • Incentive compensation.
  • 401K with company match.
  • Life and disability insurance.
  • Tuition reimbursement.
  • Employee referral bonus.

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