Pharmacy Customer Service Representative

Tampa, FL | 4 Months

Post Date: 11/08/2017 Job ID: WCG1JP00004277 Industry: Healthcare

Customer Service Representative ---- Reports To (title): Supv. Customer Service ---- Date Last Revised: 4/21/2015 ---- FLSA Classification:: Non-Exempt ---- Job Function/Family: Operations\Customer Service ---- JOB SUMMARY ---- Responds to member and provider inquiries (phone. written or walk in) regarding all aspects of WellCare business. including claims. in a professional. timely. accurate and caring manner while consistently meeting all guidelines. ---- ESSENTIAL FUNCTIONS ---- Note: The following is not intended to be an exhaustive list of all duties required of this position ---- Key Duties and Responsibilities ---- Responds to member. provider and other inquiries via telephone. correspondence or lobby walk-in while meeting all corporate guidelines and performance standards.---Demonstrates appropriate customer-care skills such as empathy. active listening. courtesy. politeness. helpfulness and other skills as identified.---Records. investigates and resolves member complaints as detailed in the Grievance Procedure narrative.---Assists in the education of new members and in the re-education of existing members regarding health plan procedures.---Logs. tracks and appropriately documents all issues utilizing on-line systems and procedures. and in accordance with all applicable guidelines and requirements.---Makes decisions that are consistent with the concept of a win-win-win for members. associates and WellCare.---Demonstrates based behaviors such as initiative. accountability and value.---Performs skills necessary to create a high-quality customer experience. as reflected through acceptable C-Sat scores. quality monitors and member feedback.---Performs other duties as assigned. ---- Additional Position Responsibilities ? Optional ---- ---- MINIMUM QUALIFICATIONS ---- Education ---- State the minimum required for the job ---- Education Level Education Details Required/Preferred ---- A High School or GED Required---or equivalent work experience Required ---- Work Experience ---- State the minimum required for the job ---- Experience Level Experience Details Required/Preferred ---- 6 months of experience in relevant work Required---Other Previous experience in a call center or customer service environment Preferred ---- Licenses and Certifications ---- List professional licenses and certifications associated with this job ---- Licenses/Certifications Other Licenses/Certifications Required/Preferred ---- Other Customer service. quality or training certifications Preferred ---- Skills ---- State the minimum required for the job ---- Skill Sets Other Skills Proficiency ---- Demonstrated written communication skills Advanced---Demonstrated interpersonal/verbal communication skills Advanced---Ability to multi-task Ability to multi-task. good organizational and time management skills Advanced---Demonstrated organizational skills Intermediate---Demonstrated time management and priority setting skills Intermediate---Ability to effectively present information and respond to questions from peers and management Intermediate---Ability to create. review and interpret treatment plans Intermediate---Other Ability to act on feedback provided by showing ownership of his or her own development Intermediate---Other Ability to read. analyze. and interpret verbal and written instructions Intermediate---Other Seeks to build trust. respect and credibility with all partners through full. honest. consistent. and coordinated communication Intermediate---Other Ability to define problems. collect data. establish facts and draw valid conclusions Intermediate ---- Technology ---- List technical skills associated with the job ---- Technology Other Technology Proficiency Required/Preferred ---- Microsoft Outlook Intermediate Required---Microsoft Word Intermediate Required---Microsoft Excel Intermediate Required ---- Languages ---- List all that apply ---- Languages Other Languages Required/Preferred ---- ---- SCOPE ---- Level of Supervision Received: ---- A statement which describes the level of independence for this position. ---- [X] Under general supervision. proceeds alone on regular duties. referring questionable cases to supervisor. ---- Level of Supervision Exercised: ---- (Select all that apply) Positions Supervised ---- [X] Individual Contributor 1 [ ] (Please check all that apply) ---- Impact: ---- A statement which describes the impact to the company regarding contributions. decisions. recommendations or actions taken by the incumbent. ---- [X] Failure to accomplish results can normally be overcome without significant effect on the organization ---- Problem Complexity: ---- A statement which describes how clearly a problem is defined when presented. how much additional effort is required to understand the nature of the problem and the typical timescales for resolution. ---- [X] Provides resolution to problems that are readily identifiable with limited scope and are resolved in accordance with standard practices. procedures. applications or routines. ---- PHYSICAL DEMANDS AND WORKING CONDITIONS ---- Physical Demands ---- While performing the duties of this job. the associate is required to meet the following physical demands: ---- ---- The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job_ Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. ---- Working Conditions ---- While performing the duties of this job. the associate is required to meet the following working conditions: ---- Working Condition None Seldom Occasionally Frequently ---- ---- The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job_ Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.


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