Member Care Advocate

Jobtailor; Washington (Washington County); On-site; USD 36,000 - 48,000; Full time

Job summary

Jobtailor is seeking a detail-oriented Pharmacy Technician to handle high-volume inbound and outbound calls and emails from members, pharmacies, and physician offices in Washington. You will troubleshoot claim issues within the adjudication system and provide engaging, patient-focused service.

The role emphasizes customer service experience, familiarity with prescription claims processing, and the ability to multitask in a fast-paced environment.

Qualifications

• Pharmacy Technician experience is strongly preferred.
• Comfort and stamina for being on the phone the majority of the workday.
• Proven customer service experience, ideally in a call center or pharmacy setting.
• Knowledge of prescription claims processing is highly helpful.
• Analytical thinking and sharp attention to detail.
• Excellent communication and customer relations skills.
• Strong problem-solving skills.
• Ability to multi-task and prioritize in a fast-paced, ever-changing environment.
• Strong computer skills, including Microsoft Office (Excel, Word, PowerPoint, Outlook).
• High School Diploma and/or college degree in a related field preferred.

Responsibilities

• Manage a high volume of daily inbound and outbound phone calls and emails from members, clients, pharmacies, and physician offices
• Troubleshoot claim processing problems and inquiries directly in the claims adjudication system while maintaining an engaging phone presence
• Respond promptly to website inquiries
• Become proficient in all aspects of the claims adjudication system
• Communicate recurring problems and systemic concerns to the manager
• Respond to member and client inquiries
• Assist members with navigating their prescription benefits
• Problem-solve complex issues in the claims system
• Provide administrative support to Member Care leadership, Client Success, and Executive teams
• Provide care and service to callers needing assistance

Skills

Customer service

Analytical thinking

Attention to detail

Multi-tasking

Problem-solving

Communication skills

Adaptability

Engaging phone presence

Phone support

Education

High School Diploma or related degree

Tools

Microsoft Office

Excel

Word

PowerPoint

Outlook

Job description

• Manage a high volume of daily inbound and outbound phone calls and emails from members, clients, pharmacies, and physician offices


• Troubleshoot claim processing problems and inquiries directly in the claims adjudication system while maintaining an engaging phone presence


• Respond promptly to website inquiries


• Become proficient in all aspects of the claims adjudication system


• Communicate recurring problems and systemic concerns to the manager


• Respond to member and client inquiries


• Assist members with navigating their prescription benefits


• Problem-solve complex issues in the claims system


• Provide administrative support to Member Care leadership, Client Success, and Executive teams


• Provide care and service to callers needing assistance

Requirements

• Pharmacy Technician experience is strongly preferred


• Comfort and stamina for being on the phone the majority of the workday


• Proven customer service experience, ideally in a call center or pharmacy setting


• Knowledge of prescription claims processing is highly helpful


• Analytical thinking and sharp attention to detail


• Excellent communication and customer relations skills


• Strong problem-solving skills


• Ability to multi-task and prioritize in a fast-paced, ever-changing environment


• Strong computer skills, including Microsoft Office (Excel, Word, PowerPoint, Outlook)


• High School Diploma and/or college degree in a related field preferred

Core Competencies

Proficient in claims adjudication systems with strong customer service skills, capable of troubleshooting complex issues and providing administrative support in a fast-paced environment.

Highest-signal resume keywords

• Pharmacy Technician Experience


• Claims Processing Knowledge


• Customer Service Experience


• Analytical Thinking


• Strong Communication Skills

ATS Optimization Keywords

Hard Skills

• Claims Adjudication


• Prescription Claims Processing


• Multi-tasking


• Problem-solving


• Attention to Detail

Soft Skills

• Customer Relations


• Engaging Phone Presence


• Adaptability

Industry Keywords

• Call Center


• Pharmacy Setting


• Member Care


• Client Success

Tools & Technologies

• Microsoft Office


• Excel


• Word


• PowerPoint


• Outlook