FIND YOUR FUTURE

We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and commitment to diversity and inclusion.

Overview

The Servicing Representative is a customer service professional who displays confidence, a passion for service, and practices empathetic listening towards all Pharmacy Benefit Dimensions (PBD) customers. The Servicing Representative functions as an advocate for all customers and resolves all inquiries (i.e., phone, mail, fax, and email.) They Servicing Rep utilizes system tools and resources to address and resolve inquiries; provide benefit clarification and eligibility; communicate claim and reimbursement information, facilitate proper utilization of policies and procedures, coordinate resolution to streamline processes; make demographic changes; and educate customers on regulatory policies and procedures.

Qualifications

• High School or GED required; Associate degree preferred

• Six (6) months experience working for a health insurance company, physician’s office or pharmacy required. Experience handling self-funded pharmacy calls preferred.

• Experience in a call center operations environment preferred.

• Demonstrated ability to effectively communicate with internal and external customers. Excellent written/verbal communication skills, excellent customer service skills.

• Experience handling high volume, inbound and outbound phone calls preferred.

• Demonstrated ability to listen with intent to understand.

• Demonstrated proficiency to verbally translate written communication. Typing 35-40 words a minute required.

• Demonstrated proficiency in problem solving and proven ability to prioritize accordingly.

• PC and Windows experience with proficient typing skills and ability to utilize multiple system tools simultaneously.

• Strong organizational/time management skills

• Proven examples of displaying the PBD values: Trusted Advisor, Innovative, Excellence, Guardianship, Dedication and Caring.

Essential Accountabilities

Servicing

• Responsible for acting as a customer advocate by providing excellent customer service when answering customer phone calls, written correspondence and servicing walk-in members in a timely fashion. De-escalate customers as needed and resolve customer complaints.

• Ensure that our customers are obtaining accurate and up-to-date information on policies and procedures and communicate a successful resolution to inquiries.

• Ensuring compliance with all CMS rules and regulations.

• Log all contacts into appropriate systems.

• Meet or exceed all department standards in the following categories as measured and recorded the representative’s scorecard:

• Quality goals - measure Representative’s ability to consistently respond to customers with excellent customer service.

• Productivity goals - measure Representative’s ability to be productive and use time effectively and efficiently. Includes average talk plus hold time, after call work (ACW), adherence, use of non-available states, tardiness and attendance.

• Accuracy goals - measure Representative’s ability to respond to inquiries correctly and accurately.

Technical Proficiency

• Maintain technical knowledge regarding Pharmacy Benefit Dimensions’ contracts and benefits and working knowledge of policies and procedures and maintaining updates on a daily basis. Attend required training sessions as needed.

• Provide accurate and up-to-date information to all customers by documenting all pertinent information into appropriate systems to meet regulatory agency standards (NCQA, State, CMS etc.), addressing first level complaints and providing assistance on appeals as needed; receive and effectively resolve written inquiries from members regarding claims, benefits, eligibility, reimbursement and participating providers.

• Knowledge of all systems (Siebel, HealthRules, RxClaim, Macess, Reveal, E-mail and other systems as needed) and training manuals and the ability to coordinate the use of these tools at the same time.

Administrative Duties

• Other duties as required by immediate supervisor which may include servicing walk-in members, correspondence support and making outbound phone calls.

Hiring Compensation Range: $19

Compensation may vary based on factors including but not limited to skills, education, location and experience.

In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future.

As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant’s race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law. Click here (http://www.independenthealth.com/about/careers/additional-eeo-aap-information) for additional EEO/AAP or Reasonable Accommodation information.

Current Associates must apply internally via the Job Hub app.

The Independent Health Family of Companies, headquartered in Buffalo, NY, serves nearly 400,000 members and provides innovative health care products and benefits designed to engage consumers in their health and well-being. Established in 1980, our comprehensive portfolio includes Pharmacy Benefit Dimensions, Reliance Rx, Nova Healthcare Administrators, Care for You and the Independent Health Foundation.

Our culture sets us apart. Our core values drive who we are and the work we do. As a member of our family, you’re part of something special, in your work and in the community.

We understand and appreciate that everyone has unique experiences, perspectives and identities which is why we pledge to create a safe space where all people and ideas are welcomed. We are here to continue learning and to generate important dialog.

We are committed to doing what matters most - reaching out, working together, and caring for our community. A healthy community benefits everyone who lives in it. You too can be part of making difference in the lives of others, together we achieve so much more. Please click here (http://www.independenthealth.com/about/community-report) to view our Community Reports.

Apply today and join us on the journey to a happier, healthier, and more inclusive community.

We are committed to providing reasonable accommodations for qualified individuals with disabilities and disabled veterans. We are a drug-free workplace. An applicant for employment in need of an accommodation to participate in the application and recruitment process should contact Human Resources at: accommodations@independenthealth.com or Human Resources, 511 Farber Lakes Drive, Williamsville, NY 14221.

Please note, we do not accept unsolicited resumes. We do not accept resumes from headhunters, placement agencies, or other suppliers that have not signed a formal agreement with us.