Serve as first point of contact for clients for all Contact Center related requests and problem resolution
Responsible for all aspects of service for assigned book of business, including member, pharmacy, physician, and client requests
Operates as the liaison between multiple business areas in researching and resolving client specific issues, implementing process changes and new products, and training all staff members
Develops and maintains excellent working relationships with clients
Partners with various departments such as Configuration Services, Accounting, Pharmacy Networks, GPS and Account Managers to ensure that clients receive timely responses
Stay current with and apply CMS requirements for Medicare Part D call center activities and understand how the company manages these regulations
Provide consultation and recommendations for clients regarding the regulations and ensure all Contact Center processes provide high quality and compliant customer service
Develop and implement strategic project planning that provides mutual performance objectives
Communicate status reports for management, clients and the project team.
Analyze data to improve strategic decision making and implementation
Requirements
BS/BA and 2+ years’ experience or equivalent combination of education and experience
Intermediate knowledge of Microsoft Office Suite, Word Processing software, MS Project, and Visio software
Experience with Windows based database programs is also required
Knowledge of healthcare operating systems in PBM industry preferred
Detailed understanding of claim processing concepts
Experience with Medicare Programs and enrollment and claim adjudication preferred
Ability to prioritize urgent issues effectively and ability to effectively balance a high volume of work
Detail oriented with a high degree of accuracy & follow through.
Self-starter with the ability to work independently and as part of a team.
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