Contact Center Specialist I

Job Opportunity At MedImpact Healthcare Systems, Inc.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

The Contact Center Specialist provides research support for multiple internal departments including Contact Center, Prior Authorization, Claims, Configuration Services, Pharmacy Network Management, Client Teams, Legal and Accounting. Provides direct member support through internet email requests, Partners with Business Solutions on the client support team for MedAccess requests, and Sales Force Requests. Supports direct client requests to meet service commitments. Ensures client requirements are being met by reviewing design set up and claims adjudication. Provides suggestions to improve workflow processes. Great follow through skills to ensure deadlines are met in a consistent manner. Managing escalation procedures and improving customer satisfaction through prompt and accurate internal and external coordination. Document all developments and interactions for positive resolutions.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Act as primary escalation point of contact for CSR's members, doctors, and pharmacies. Ability to de-escalate upset callers in an efficient and knowledgeable manner.
• Responsible for coding claims and claims processing in the manner agreed upon by contract with the client and in accordance with company policy and procedures, including regulatory / compliance requirements.
• Responds to inquiries via several communication channels : high level escalations calls, physicians' inquiries, and internal employees.
• Determines the correct course of action for problem resolution by extensively researching our internal systems.
• Evaluate and identify claims processing training needs, makes recommendations for enhancements.
• Identifies and keeps records of concerns, grievances, and error trends to develop weekly communications to the CSR's. Participates in staff meetings, periodic training programs, and other courses that will aid and maintain skills needed to be successful to this role.
• Coordinate written notification to members, physicians and pharmacies following regulatory guidelines for claims that are missing information.
• Creates and monitors Sales Force cases for CS Coordinator queue and Claims queue.
• Responsible for managing claims inbox, customer service inbox, and ops research inbox.
• Keep records of customer interactions and transactions, details of inquiries, complaints, and comments, as well as action taken for audit and appeal purposes.

Supervisory Responsibilities : No supervisory responsibilities

Client Responsibilities : This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills. One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.

Qualifications : To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and / or Experience : GED / HS Diploma and 2+ years' experience or equivalent combination of education and experience

Computer Skills : Intermediate knowledge of MS Office / Word, Excel, and Outlook and aptitude for new programs. Experience with Windows based SharePoint and database programs is also required.

Certificates, Licenses, Registrations : Current Pharmacy Technician License or National CPhT certification without restriction preferred.

Reasoning Ability : Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Mathematical Skills : Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs. Ability to add and subtract two-digit numbers and to multiply and divide with 10's and 100's. Ability to perform these operations using units of American money and weight measurement, volume, and distance.

Language Skills : Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.

Competencies To perform the job successfully, an individual should demonstrate the following competencies :

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.

While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and / or move up to 25 pounds.

Work Environment : 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.

This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples : business office with computers and printers, light traffic).

Work Location : This position must work on-site at the San Diego Headquarters or the Tempe office for purposes of providing adequate support to internal clients; being available for face-to-face interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as for facilitation of quick and effective decisions through collaboration with stakeholders. Remote work is not an option for these purposes.

Working Hours : This is a full-time non-exempt position requiring one to be able to work overtime from time to time in order to get the job done. Therefore, one must have the ability to work nights, weekends or on holidays as required. This may be changed at any time to meet the needs of the business. The typical working hours for this position are Monday through Friday from 8 : 00am to 5 : 00pm.

Travel : This position requires no travel however attendance may be required at various local conferences and meetings.

The Perks :

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com / careers.

MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer, Male / Female / Disabilities / Veterans

OSHA / ADA :

To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer :

The above statements are intended