Remote Pharmacy Customer Support Specialist

Moda Health; Milwaukie (OR); On-site; USD 25,000 - 29,000; Full time

Job summary

Moda Health in Oregon is seeking a Pharmacy Customer Service Representative I to deliver timely and accurate responses to members and agents across Commercial and UMP plans. You will use multiple programs to answer calls about benefits, eligibility, claims, or other issues in a remote, FT capacity.

The role requires a high school diploma, 1–2 years in a fast-paced service environment, and strong math, written and verbal communication skills.

Qualifications

• High school education or equivalent experience.
• 1-2 years in a fast-paced customer service environment.
• Type a minimum of 25-wpm on a computer keyboard.
• Proficient with Microsoft Office Applications, including Word and Excel and Outlook.
• Strong verbal, written, and interpersonal communication skills.

Responsibilities

• Responds to questions and assists customers via telephone, virtual meeting platform or in person regarding their claim benefit questions from callers on both group and individual pharmacy products.
• Repeatedly analyzes situations, communicates effectively, and provides accurate information in a fast-paced environment that includes dealing with escalated situations and upset people.
• Applies mathematical skills to provide and determine correct benefit information.
• Reviews, updates, and becomes familiar with new and revised benefit information, regulations, benefit information and claim processing procedures.
• Be familiar with drug names and recognize new drugs as they are released and added to the Moda drug list.
• Requests claim adjustments required because of error or new information.
• Resolves and record complaints, appeals, and inquiries.
• Contacts physicians, pharmacies and PBM’s when necessary to answer questions and obtain or provide information.
• Works with a culturally diverse population that can vary in age.
• Provides timely follow up and return calls when required.
• Maintains departmental service standards related to phone calls.
• Continues education and training through on-the-job communication with Supervisors and/or tenured Customer Representatives and by attending trainings scheduled by leadership.

Skills

Customer service

Communication

Typing 25 wpm

Microsoft Office

Education

High school diploma or equivalent

Tools

Word

Excel

Outlook

Job description

Moda Health in Oregon is seeking a Pharmacy Customer Service Representative I to deliver timely and accurate responses to members and agents across Commercial and UMP plans. You will use multiple programs to answer calls about benefits, eligibility, claims, or other issues in a remote, FT capacity.

The role requires a high school diploma, 1–2 years in a fast-paced service environment, and strong math, written and verbal communication skills.