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Customer Resolution Associate - Remote

Role overview

Qualifications

  • High school diploma from an accredited school or equivalent GED
  • Strong verbal and written communication skills, interpersonal skills, and attention to detail
  • Demonstrated organizational and time-management skills
  • Basic math skills and general PC knowledge including Microsoft Office, Internet, and email

Responsibilities

  • Handle phone, email, and fax communications related to the concierge program
  • Process Pharmacy case management cases, including entering, reviewing, and documenting requests
  • Establish and maintain case profile; accurately enter member, prescriber, pharmacy, or drug information
  • Investigate and resolve phone inquiries in a timely manner

Key facts

Hard skills

Other skills

  • Customer Service
  • Organizational Skills
  • Detail Oriented
  • Non-Verbal Communication
  • Social Skills
  • Time Management
  • Microsoft Office

About the company

Prime Therapeutics logo

Prime Therapeutics

Pharmacy Benefit Management (PBM)

Everything we do is connected to helping people get the medicine they need to feel better and live well. It’s meaningful work and we’ve been doing it for over 24 years. In the pharmacy benefit management (PBM)industry, we’re different. We’re owned by 18 not-for-profit Blue Cross and Blue Shield health plans. This allows us to control costs and empower our employees to put members first. It’s a successful combination. We have the lowest pharmacy trend in the industry and serve 28+ million members throughout the US. In addition to core PBM services, we work closely with our clients to implement the right benefit design, clinical and specialty programs, formulary and networks. A few key products: • NetResults™ • Specialty Drug Management • Best in Care™ • GuidedHealth® • Advanced Fraud, Waste and Abuse: Member and Prescriber Investigations • Prime Analytics™ • CareCentered Contracting™Controlled Substance Management Program Join us! Prime is always looking for smart, purposeful people to join our team. We’re growing fast which means there are plenty of opportunities to advance and grow in your career. At the same time, Prime supports flexibility and offers generous PTO so you can enjoy an enviable work/life balance. We’re a privately held company -big enough to make a difference and small enough for you to have an impact. Prime’s recruiting team will only contact you via phone call or through a corporate email address. Do not respond to suspicious emails or social media messages. If you have questions or are skeptical about any follow-up communications, please contact Human Resources at 1.866.469.1257 or email Careers@primetherapeutics.com.

Company details

Company typeLarge
IndustryPharmacy Benefit Management (PBM)
Company size1001 - 5000

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Job description

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.

Job Posting Title

Customer Resolution Associate - Remote

Job Description

The Customer Resolution Associate is responsible for processing, communicating, documenting, and tracking member cases for Pharmacy Services. This position is also responsible for interacting with members, pharmacies, prescribers, or plans to provide support and assistance with program inquiries and other administrative functions.

Responsibilities

  • Handle phone, email, and fax communications related to the concierge program, including inbound and outbound functions, to members, pharmacies, prescribers, or plans
  • Process Pharmacy case management cases, including entering, reviewing, and documenting requests in both the claims processing system and case management system
  • Establish and maintain case profile; accurately enter member, prescriber, pharmacy, or drug information into case management system
  • Investigate and resolve phone inquiries in a timely manner; escalate inquiries or issues to appropriate team member as necessary
  • Manage work queues and volumes to meet client specific turnaround times
  • Other duties as assigned

Minimum Qualifications

  • High school diploma from an accredited school or equivalent GED

Must be eligible to work in the United States without the need for work visa or residency sponsorship

Additional Qualifications

  • Strong verbal and written communication skills, interpersonal skills, and attention to detail
  • Demonstrated organizational and time-management skills
  • Willingness and ability to learn internal systems/processes/programs
  • Willingness to work overtime, weekends, and holidays on a rotating basis as needed
  • Ability to adapt and work collaboratively in a dynamic fast-paced production environment
  • Basic math skills and general PC knowledge including Microsoft Office, Internet, and email
  • Ability to work a flexible schedule to accommodate business needs

Preferred Qualifications

  • Associate's degree in business, health care or related area of study
  • 1 year of customer service experience to include 6 months of work experience in Pharmacy Benefit Management (PBM) or health care

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures

Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.

Potential pay for this position ranges from $17.85 - $25.48 based on experience and skills.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits).

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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