Job Description

Job Description

Position Summary

As a PBM (Pharmacy Benefit Manager) Customer Service Email Representative, you will play a pivotal role in ensuring the satisfaction of our customers by responding to their inquiries, resolving issues, and providing information through email communication. Your primary responsibility will be to manage incoming customer service emails promptly and professionally, ensuring that each customer's needs are addressed effectively and efficiently.

Essential Duties and Responsibilities

The essential functions include, but are not limited to the following:

• Email Communication: Respond to incoming customer service emails in a timely and professional manner, ensuring accurate and helpful responses.
• Customer Support: Provide excellent customer support by answering inquiries, addressing concerns, and resolving issues related to prescription drug benefits, claims, coverage, and other pharmacy-related matters.
• Information Provision: Accurately convey information regarding prescription drug plans, formularies, prior authorizations, and pharmacy network details to members.
• Problem Resolution: Investigate and resolve member complaints or issues related to medication coverage, billing, and claims, ensuring a positive resolution for the customer.
• Documentation: Maintain thorough and organized records of all interactions, inquiries, and resolutions in the customer service email alias.
• Compliance: Adhere to all relevant policies, procedures, and compliance regulations in the healthcare and insurance industry.
• Continuous Learning: Stay updated on company policies, industry trends, and healthcare regulations to provide accurate and up-to-date information to customers.
• Collaboration: Collaborate with other customer service representatives and departments to address complex member issues and improve overall client and member experience.

Minimum Qualifications (Knowledge, Skills, and Abilities)

• High school diploma or equivalent. A bachelor's degree or relevant certification in healthcare, customer service, or a related field is a plus.
• Previous experience in customer service, preferably in a healthcare or PBM setting, is preferred but not required.
• Excellent written communication skills, with the ability to compose clear and concise emails.
• Strong problem-solving and critical-thinking skills.
• Empathetic and patient demeanor when dealing with customer inquiries and concerns.
• Proficiency in using email and customer service software systems.
• Ability to multitask, prioritize, and manage time effectively.
• Strong attention to detail and accuracy in handling customer information.