Call Centre Representative I

SGS_JOB_2362

Admin/Clerical
 Pennsylvania
Call center
Medicaid
Medicare
inbound/ outbound

Contract - 06+ Months

Location : Wilkes-Barre, PA 18702 Shift: Training: Mon-Fri 9:00am-5:30pm EST, Hours vary 7:00am-5:30pm EST Mon-Fri some Sat No pre-scheduled PTO during first 6–8 weeks This position involves extensive member contact via the telephone. Handles inbound/outbound calls from participants and/or prescribers when needed to start and process order requests. Ability to research and investigate orders using Compass and LINKS. Research issues sent by Customer Care, Account Managers, internal customers and Quality Assurance related to customer service experience. Notifying requestor of decisions, changes, or other relevant information pertaining to request/inquiry. Responsible for researching and resolving payment issues. Call to offer direct sales of medications to participants and post payments to the proper account. Perform required transactions to complete mail order prescriptions. Follow through standard operating procedures, problem-solving and troubleshooting within guidelines.

Job Responsibilities:

  • Knowledge of Medicare, Medicaid, and 3rd party vendors is a plus.
  • The primary responsibilities are to verify insurance coverage for potential new clients. Additionally, this person will re-verify insurance coverage for existing patients to process patient prescription needs success and demonstrate excellent customer services to patients, healthcare professionals, and insurance carriers.
  • This role will require an understanding of insurance concepts, including drug cards, major medical benefits, and per diem coverage, as well as knowledge of government and patient assistance programs. Strong attention to detail and proven analytic and problem solving.

Skills:

  • Candidates must have at least one year of customer service or call center experience.
  • Strong soft skills, phone etiquette, and computer proficiency (Outlook, Word, Excel) are essential.
  • Call monitoring is in place, and candidates must be comfortable with performance tracking.

Education/Experience:

  • High School diploma or GED

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