Capital Rx

Customer Care Representative

Capital Rx

full-time

Posted on:

Location Type: Remote

Location: United States

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Salary

💰 $26 per hour

About the role

  • Efficiently triage incoming phone calls with professional phone etiquette from members and pharmacies with minimal support. Ask probing questions to identify and resolve all issues and address concerns promptly
  • Provide support for call center staff, including other technicians and customer service representatives
  • Identify, accurately document, and escalate member and pharmacy concerns to the appropriate internal team including various members of the Operations Team
  • Effectively communicate issues and solutions to members, pharmacies, and relevant internal stakeholders to ensure customers receive quality care and that the resolution meets all health and safety standards
  • Communicate effectively with internal and external customers to provide first-call resolution and de-escalate customer concerns
  • Ensure customer satisfaction, extraordinary customer care, and quality resolution with genuine compassion in a fast-paced, environment
  • Follow all internal Standard Operating Procedures and adhere to HIPAA guidelines and Company policies
  • Support the Fraud, Waste, and Abuse program by reviewing pharmacy claims information and communicating findings to appropriate internal staff
  • Work with multiple systems, up to 2 monitors, and multitask in a fast-paced environment
  • Self-starter who displays a positive attitude, strong work ethic, and excellent attendance
  • Meet all departmental goals including schedule adherence, attendance, and quality monitoring
  • Standard hours for training: Monday thru Friday, 9:00am – 5:30pm, Eastern
  • Perform other customer support duties as assigned
  • Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance

Requirements

  • High school diploma or the equivalent; Associates or Bachelor’s degree preferred
  • 2+ years of customer service, call center, and/or health care experience with a passion for building customer loyalty through exceptional listening, relationship building, and strong written and verbal communication preferred
  • 2+ years of PBM or related Health Care experience required
  • Ability to work independently with minimal supervision, stay productive in a remote, high-volume, fast-paced, metric-driven call center environment
  • Bilingual Spanish highly preferred
  • Medicare experience preferred
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
customer servicecall center experiencehealth care experiencePBM experienceHIPAA compliancefraud detectionclaims reviewmultitaskingschedule adherencequality monitoring
Soft Skills
professional phone etiquetteproblem-solvingeffective communicationcustomer satisfactioncompassionself-starterpositive attitudestrong work ethicrelationship buildinglistening skills