- Must be bilingual in Spanish
Description
Convey a positive image of the company by promptly responding to customer phone inquiries and
determining the appropriate actions to resolve issues, gather and provide information, and offer
assistance.
▪ Deliver service that meets or exceeds department performance standards for Quality, Adherence, and
One-touch Resolution.
▪ Utilize multiple company applications to research and resolve complex issues relating to benefit
information, claims adjudication, eligibility verification, prior authorization, and other PBM processes.
Use established processes & tools as applicable to escalate issues, request follow up action, or obtain
assistance from other areas of the organization as necessary.
▪ Educate callers and provide information about override guidelines, benefit plan restrictions, prior
authorization requirements, grievance and appeal processes, and other PBM functions as specified by
health plan sponsors.
▪ Follow up with callers as appropriate to ensure customer satisfaction and timely response to requests.
Diffuse irate or emotionally upset customers by appropriately listening to issues, de-escalating g the
customer, and providing positive solutions to resolve concerns.
▪ Support the department strategy by delivering Customer Service Excellence through telephone
courtesy, prompt response to callers, anticipation of customer needs and concerns, solution-oriented
problem solving, and adherence to call center scripts, greetings, and call closing messages.
MedImpact Position Description Company Confidential Page 2 Of 4
▪ Identify opportunities and make recommendations to department leadership for improvement of
workflow processes, operating systems, training programs, reference materials, and quality initiatives
that enhance the customer experience.
▪ Keep current on new plan information and instructions by attending and participating in staff meetings,
huddles, company-required training programs, and other activities that develop skills, build teamwork,
and provide updated information.
Skills
Customer service, Customer support, Call center
Top Skills Details
Customer service,Customer support,Call center
Additional Skills & Qualifications
call center
customer service
Bilingual Spanish
PBM
pharmacy
healthcare
Experience Level
Entry Level
About TEKsystems
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
