Pharmacy Member Services Representative

Adventist Health System; Town of Florida (NY); Remote; USD 35,000 - 50,000; Full time

Job summary

A healthcare organization is seeking a Member Services Representative to support members of the Prescription Plan through customer service and data management tasks. The role requires effective communication, problem-solving, and proficiency in MS Office. Applicants should have a high school diploma and at least 2 years of customer service experience. This position includes remote work after 90 days of successful training.

Benefits

Benefits from Day One

Paid Time Off from Day One

Career Development

Mental Health Resources and Support

Qualifications

• 2+ years of customer service experience.
• Basic proficiency in MS Office: Word, Excel, Skype, and Outlook.
• Experience in mail-order or healthcare preferred.

Responsibilities

• Perform patient outreach and education.
• Ensure timely prescription fulfillment.
• Deescalate unsatisfied callers and maintain productivity expectations.
• Document member follow-up and communicate effectively.

Skills

Customer service

Data entry

Communication

Problem-solving

Education

High School Graduate or equivalent

Tools

MS Office

Job description

Overview

All the benefits and perks you need for you and your family:

• Benefits from Day One
• Paid Time Off from Day One
• Career Development
• Whole Person Wellbeing Resources
• Mental Health Resources and Support

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Schedule: Full Time

Shift: Monday – Friday, 8:30am – 5:00pm

Location: 5050 Wesley Rd Apopka, FL 32712 (Position will be remote after 90 days of successful completion of training)

The role you’ll contribute

The Member Services Representative performs a wide range of duties to support the members of the AHS Corporate Prescription Plan regarding plan questions and mail-order pharmacy requirements. Primary and shared duties include, but are not limited to, patient outreach and education, extensive data entry, compiling, reconciling and maintaining records. The Member Services Representative's primary duties are divided amongst three team positions as described further and assigned by the Member Services Manager. This position works directly with patients and is required to understand multiple aspects of the facility and its processes to ensure accurate information and provide exceptional service to members. Additional duties may include assisting with answering incoming phone calls, if needed and when deemed necessary by leadership, as well as assisting with other areas of the department as needed. Works only under the supervision of a registered Pharmacist and does not perform duties that can only be legally performed by a registered Pharmacist or registered Pharmacy Technician.

The value you’ll bring to the team

• Ensures timely outreach and prescription fulfillment within the member’s plan design requirements.
• Follows guidelines when faxing refill requests and sending electronic requests to physician’s offices.
• Leaves thorough and comprehensible notes in the member’s profile for any issue that needs to be communicated to other staff members.
• Documents and addresses member follow-up such as credit card rejections and price alerts.
• Accurately and completely registers members and family members, including online registrations, verifying all updated information.
• Researches each prescription follow-up by verifying member’s address, checking shipping date, reviewing member’s profile, and providing delivery confirmation information if requested.
• Deescalates unsatisfied callers and converts a negative communication to a positive and helpful exchange.
• Answers phone within established productivity expectations, does not leave patient on hold long periods of time, and offers to call back patient if researching a request.
• Understands thoroughly the prescription plan and communicates with members any questions regarding the prescriptions, copay structures, and prior authorization process.
• Other duties as assigned.

The expertise and experiences you’ll need to succeed

EDUCATION AND EXPERIENCE REQUIRED:

• High School Graduate or equivalent
• 2+ years of customer service experience
• Basic proficiency skill set in MS Office: Word, Excel, Skype and Outlook

EDUCATION AND EXPERIENCE PREFERRED:

• Previous experience in mail-order, medical, or healthcare related area