LOCATION: REMOTE || Must reside in California
DURATION: 9-month contract with high potential for extension and possible full-time conversion
PAY RATE: $18.83/hr. on W2 contract.
IMPORTANT NOTES:
Work Schedule:
- Candidate must be open to work on weekends.
- Shifts are 8 hours between 6:00 AM – 10:00 PM Pacific Time (no graveyard/overnight shifts). Schedules may include any 5 days of the week. Shift time will be confirmed upon job offer as we are hiring over 40 candidates (Candidate should be open to start anytime between 6AM to 1:30PM, shift will be assigned after the training.)
- Candidates must be available to work either one or both weekend days as assigned. Overtime is not regularly expected but may be available on a voluntary basis.
Training Requirements:
- 6 weeks of paid training. 8:00 AM – 5:00 PM PT
- No time off permitted during training.
- Excellent attendance is expected during the first 90 days of employment.
Work-From-Home Related:
- Must reside within the state of California.
- Equipment provided. Must have a hard-wired internet connection (Wi-Fi is not permitted due to PHI/security requirements). Client provides a 2-meter Ethernet cable; candidates may need to purchase a longer cable if necessary.
- Quiet, distraction-free workspace required. Must have a desk/table and office chair. Must be comfortable using a webcam during training, meetings, and as requested by management.
JOB RESPONSIBILITIES:
- The main function of a Member Service Representative is to interact with customers to provide information in response to inquiries about products and services and to handle and resolve complaints. A typical Representative is responsible for determining the client's issue, offering possible solutions, or providing follow-up as needed. Customer service representatives may handle inbound, outbound, or blended calls.
- Resolve customer service or billing complaints by processing account adjustments, refunds, or other appropriate resolutions.
- Respond to customer inquiries regarding pharmacy benefits, claims, eligibility, billing, and related services.
- Contact customers regarding claim investigation results and planned adjustments.
- Escalate unresolved customer concerns to the appropriate departments.
- Accurately document customer interactions, inquiries, complaints, and resolutions.
- Navigate multiple computer systems while maintaining productivity and accuracy.
- Meet quality, productivity, and customer satisfaction expectations in a high-volume call center environment.
JOB REQUIREMENTS:
- High school diploma or GED required.
- 0–2 years of customer service experience required.
- High-volume call center/customer service experience required.
- Healthcare or pharmacy call center experience is strongly preferred.
- Previous experience using MS Outlook, data entry applications, and multiple computer systems.
- Proficiency navigating dual monitors and multiple software applications simultaneously.
- Ability to accurately document customer information.
- Strong critical thinking, problem-solving, and conflict resolution skills.
- Excellent verbal and written communication skills.
- Ability to work independently in a remote environment.
- Ability to maintain confidentiality while handling protected health information (PHI).
PREFERRED QUALIFICATIONS:
- Pharmacy or healthcare customer service experience.
- Experience supporting Medicare, Medicaid, or health insurance members.