Member Care Advocate

TrueScripts Management Services, LLC; Washington, Northern (IN, KY); Hybrid; USD 42,000 - 54,000; Full time

Benefits offered by this job

Health insurance options

Bonus program

401k with company match

ESOP transition

Employee Assistance Program

Wellness program with incentives

Dream Manager Program

Cohesive family-based culture

Charitable contributions

Celebrations

Job summary

TrueScripts Management Services, a pharmacist-founded PBM, is seeking a Member Care Advocate to handle in-house and client/member communications. As a phone-based advocate, you will respond to inquiries, help members navigate prescription benefits, and resolve complex claims issues with a focus on delivering Amazing Care.

This is an in-office/remote hybrid role requiring 2+ days per week in our Washington, Indiana location.

Qualifications

• Pharmacy Technician experience strongly preferred.
• Ability to handle high-volume phone support.
• Customer service experience in call center or pharmacy setting.
• Knowledge of prescription claims processing is helpful.
• Strong communication, attention to detail, and problem-solving.
• Proficient with Microsoft Office (Excel, Word, PowerPoint, Outlook).

Responsibilities

• Manage high-volume inbound/outbound calls and emails from members, clients, pharmacies, and physician offices.
• Troubleshoot claim processing problems in the claims adjudication system.
• Respond promptly to website inquiries and become proficient in the adjudication system.
• Provide administrative support to Member Care leadership and teams.
• Deliver amazing care to callers and represent the company’s values.

Skills

Customer service

Phone-based work

Analytical thinking

Problem solving

Communication skills

Multi-tasking

Microsoft Office

Claims processing

Education

High School Diploma

College degree in a related field (preferred)

Tools

Microsoft Office

Claims adjudication system

Job description

Description

TrueScripts Management Services is a pharmacist-founded, fully transparent Prescription Benefit Manager that has been revolutionizing the PBM industry since 2014. Our mission is to build lasting relationships by providing prescription benefit expertise at a personal and customized level to ensure optimum value at the lowest possible cost. We are committed to lowering prescription drug spending, achieving clinically effective outcomes, and always delivering Amazing Care. Did we mention Amazing Care? Good! Because this is so much more than just our tagline. It is the foundation upon which our business was built. We believe that Amazing Care starts from within, and our culture is reflective of this philosophy.

Our team members enjoy:

• A wide range of health insurance options including medical, dental and vision
• A strong salary and bonus program
• A robust 401k and company match
• Truescripts is transitioning to an ESOP, a team member owned company! Each year team members are allocated shares of stock through our ESOP, a Qualified Retirement plan!
• Employee Assistance Program
• A wellness program including financial incentives, chiropractic and massage services, and fitness stipends
• Dream Manager Program (yes, it’s a real thing!)
• A cohesive, family-based culture
• Charitable contributions and volunteer time
• Lots of celebrations!

Ok, enough about us. Here’s what we need from you: A future team members' values need to align with TrueScripts' core values of Integrity, Respect, Innovation, and Service. This match in value systems is critical for our team's chemistry and continued success. Our culture is positive, and our people possess a ‘can do, proactive attitude. Honesty and transparency are the foundation that we build upon. What sets us apart from our competitors is the programs that we bring, the education that we provide, and the utmost respect for clients and their members to assist them when and where needed.

Position Summary

The Member Care Advocate is responsible for performing all tasks relative to in-house and external communications with TrueScripts' clients and members. As a phone-based advocate, you can expect to spend the majority of your day actively engaging with callers. You will respond to member and client inquiries, assist members with navigating their prescription benefits, and problem-solve complex issues in the claims system. This role also provides vital administrative support to our Member Care leadership, Client Success, and Executive teams. Most importantly, you will provide amazing care to those who call and need our help and service. **This is an in-office/remote hybrid role requiring 2 or more days a week in office at our Washington, Indiana location.**

Pharmacy Technician experience is highly preferred for this role to help navigate clinical and claims complexities seamlessly.

Core Responsibilities

Account Inquiries & Claims Processing (High-Volume Phone Support)

• 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.

Requirements & 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.