Call Center Representative

• Offer subject matter expertise to patients and handle escalated calls
• Manage Salesforce and our message center
• Handle insurance tasks
• Set an example by meeting SLAs consistently
• Occasionally lead team huddles and meetings
• Attend on-boarding and learn about OrthoFi’s culture
• Train in our OrthoFi Software
• Complete customer service and collections specific on-boarding curriculum
• Handle all outbound and inbound communications with financially responsible parties

Bilingual Orthodontic Contact Center Representative

• Verifies member information and inputs data for the pharmacists
• Educates members about prescriptions and medication resources or assistance programs
• Educates members on medication adherence-related topics to align closely with STARs Ratings and HEDIS quality measures
• Assists members with scheduling their preventive tests/screenings and medication resources or assistance programs
• Makes outreach to members or providers to close care gaps and improve outcomes

Pharmacy Tech II – CarelonRx Call Center

• Provides evaluation of member Rx needs and therapies through review of medication history
• Assesses member compliance with plan through direct contact with members and their physicians
• Determines potential barriers to compliance and identifies solutions to overcome barriers
• Ensures that members understand appropriate use of current prescriptions
• Reviews medications with physicians when therapies do not meet national standards and counsels physicians around alternative medications
• Serves as a resource to the clinical team in disease management and other clinical areas

Pharmacist Consultant – CarelonRx Call Center

• Design, implement, and manage IVR flows, contact routing, and queue structures using Genesys Cloud Architect for inbound/outbound calls, email, and SMS.
• Perform full platform administration, including users, campaigns, scripts, prompts, and permissions.
• Develop and maintain custom integrations with internal systems and third-party applications using Genesys Cloud APIs (RESTful), webhooks, and secure connectivity protocols such as OAuth.
• Configure and optimize data actions, reporting, and contact center features to support business teams.
• Create and update campaigns and contact lists for outbound operations.
• Contribute to Agile ceremonies (sprint planning, code reviews, retrospectives) and maintain documentation for workflows, integration patterns, and deployment processes.
• Troubleshoot complex issues across voice technology, routing logic, and integration points.

Lead Software Engineer – Genesys Cloud, Contact Center, IVR

• Make a high volume of outbound calls daily to members regarding cases received from health plans.
• Collect and verify member information by phone, ensuring accuracy and completeness.
• Accurately document all member interactions and update records in the system before case assignment.
• Perform repetitive outreach and data verification tasks with consistency and attention to detail.
• Address member questions or concerns, escalating to a Client Services Consultant as needed.
• Collaborate with the Client Services team to ensure smooth handoff and thorough information transfer.
• Conduct follow-up calls as necessary to gather outstanding information prior to case assignment.
• Adhere to company policies, procedures, and all data privacy regulations while handling sensitive information.

Member Outreach Coordinator – Call Center

• Serve as the ambassador and voice for ProMedica’s HIM department and myChart support
• Provide a positive first impression to patients
• Effectively communicate the process of obtaining medical records
• Help myChart users with questions about the app
• Keep a record of all requests
• Accept and post payments to release of information about patient accounts

HIM Call Center Representative

• Providing an exceptional customer service experience each day in a phone-based environment
• Answering a high volume of inbound calls from current patients and serve as an ExactCare expert to resolve their questions
• Placing outbound calls to patients to create, maintain or update their medication profiles
• Effectively assist with patient questions over the phone
• Working through current case queues to problem solve for patient care issues
• Serving as a liaison between the clinical pharmacists and other medical professionals on patients’ behalf
• Perform claim adjudication and auditing duties such as prior authorizations, billing and eligibility checks
• Collect on patient balances when patient has an amount due
• Maintaining patient records with strong attention to detail and confidentiality
• Utilizing sound drug knowledge to effectively receive prescription authorizations, clarifications or transfers
• Accurate retrieval of all prescription information and verifying through doctor calls
• Entering a high volume of data; processing prescription information with speed and accuracy
• Placing welcome calls to newly onboarded patients and establish a trusted point of contact
• Partner with technicians and pharmacists to ensure that new patients are successfully onboarded to ExactCare
• Performing in a high volume, fast paced environment to support ExactCare’s nationwide patient base
• Embodying AnewHealth’s Core Values in all communications and interactions

Certified Pharmacy Technician – Call Center Claims Adjudication

• Provide Telephony & Routing Analytics Support across inbound, outbound, and IVR call flows.
• Maintain and monitor key workforce and telephony KPIs to inform short- and long-term capacity models, including handle time, utilization, shrinkage, and volume trends.
• Manage and support the flow of telephony and interaction data from NiCE platforms into Enterprise Data Analytics environments.
• Identify, investigate, and resolve data discrepancies between telephony platforms, workforce systems, and downstream reporting.
• Execute ad hoc reporting requests to support leadership inquiries, operational reviews, and cross-functional initiatives.
• Deliver Workforce & Operational Insights by analyzing agent performance, volume patterns, and routing outcomes to surface risks and opportunities.
• Support TFN, IVR, and Telephony Structure by validating routing logic, number assignments, hours of operation, and queue configuration.
• Proactively flag routing anomalies, call distribution issues, or performance irregularities and partner with Operations, Technology, and Platform teams on remediation.
• Contribute to documentation of data definitions, KPI logic, and telephony reporting standards to promote consistency and transparency.

Manager, Contact Center Operations – Insights

• Manage the registration, scheduling, and rescheduling processes for new and existing patients.
• Ensure accurate record management by obtaining and communicating relevant patient information, such as identification, patient history, insurance details, missed appointment policy, therapist arrival instructions, and intake forms.
• Receive, screen, and coordinate telephone calls from healthcare providers.
• Proactively make outbound calls and send emails to patient leads.

Patient Onboarding Associate – Call Center

• Responsible for answering member inquiries received through the telephone, email, or chat.
• Using technical skills and knowledge of products and services, this position will address issues, provide support, and offer information, to enhance the member experience.
• Provide first contact via telephone or electronic messaging – respond to secure messages and online chat – to build rapport with members, process requests, respond to inquiries and resolve issues with accuracy; inquiries including but not limited to: Account information, transfer requests, loan payments, withdrawals, Loyalty Reward level usage, check order and supplies, online banking services, stop payments, wire transfers, and penalties
• Assess situations, apply sound judgement and use troubleshooting skills to assist members
• Look for opportunities to introduce products and services to help members financially
• Develop and retain a broad range of knowledge of all Credit Union products and services, from both a technical and information standpoint
• Manage and utilize time efficiently to ensure service quality and member satisfaction
• Prevent possible disclosure of sensitive information to unauthorized individuals by verifying caller data utilizing differing sources as necessary
• Assist in online banking access including troubleshooting problems and errors for device and browser issues
• Research and assist with card problems (VISA and VISA debit) maintenance and problems including disputes and tokenization
• Research ACH issues and locate originators
• Assist managers in operational process for opening and closing the Contact Center
• Follow-up with member related issues as needed

Contact Center Representative

• Answer inbound calls and search database or reference material to obtain needed information to transfer caller to appropriate destination within established metrics and productivity standards.
• Navigate through the QGenda on-call system to identify on-call provider and process on-call via alpha page or phone call to the provider with patient details.
• Process special protocols for Main Campus, including Shock Team, LVAD, Patients Plus, Transplant and Ortho Reconstruction Hotline.
• Handle calls for multiple hospital sites, including Main Campus, Avon Hospital, Euclid Hospital, Hillcrest Hospital and South Pointe Hospital.
• Offer special assistance to persons who are unable to dial or are in emergency situations.
• Provide relay service for hearing impaired callers.
• Answer routine questions and provide information to the public about the organization using electronic database and other tools and reference materials.
• Perform various data entry tasks, such as updating application database, phone directories and other electronic reference material.
• In emergency situations, answer internal medical emergency calls as a backup to maintain business continuity.
• Work in Epic to view or look up patient information using the house census and provide patients with appointment details such as location, provider, date/time, etc.

Contact Center Support Operator I

• Manage a high volume of inbound and outbound calls
• Provide exceptional customer service
• Schedule patient appointments accurately using the organization's EMR system
• Assist patients in rescheduling or canceling appointments
• Verify and update patient demographic and insurance information
• Document all patient interactions and maintain accurate call records
• Collaborate with clinical staff and other departments to ensure a seamless patient experience
• Follow HIPAA regulations to maintain patient confidentiality and data security

• Coordinate and oversee daily workflows to ensure work is completed accurately.
• Support Team Leads with daily operational issues and production challenges.
• Monitor performance metrics and conduct regular KPI reviews for Team Leads.
• Provide direct supervision and leadership to Team Leads (typically 5–10).
• Partner with IT to identify, test, and implement system enhancements.

Medical Call Center Manager

• Responsible for engaging with prospective clients with the goal of setting appointments for the sales team
• Be a subject matter expert and be able to communicate the value of company products and services to help educate prospective clients
• Handle a high volume of inbound/outbound calls and meet performance goals of converting calls to appointments
• Follow the designated sales process for appointment setting including confirming full and accurate client information
• Ensure all activity and information is accurately logged in CRM
• Provide a high level of customer service to ensure each prospective client and potential customer has a positive experience with Bath & Cabinet Experts

Call Center Representative – Outbound Appointment Setter

• Conduct outbound calls to patients that qualify for adherence-based programs, ensuring timely and consistent communication
• Address patient concerns, troubleshoot issues, and provide appropriate resolutions, ensuring patient satisfaction and program success
• Identify clinical support needs and escalate calls to Pharmacists on the team to further discuss concerns
• Use CVS Procedures and guidelines to handle patient prescription requests within HIPAA guidelines
• Utilize computer systems, software, and databases to accurately record patient information and interactions
• Maintain confidentiality and adhere to all relevant patient privacy regulations and company policies during all interactions and data handling processes
• Collaborate with cross-functional teams to identify areas for program improvement
• Identify and communicate issues to senior level staff as appropriate

Tech, RX Call Center

• Reporting to the Senior Manager of Quality & Compliance, responsible for the governance, design, and oversight of compliance programs supporting contact center operations for dispensing pharmacy and non-commercial pharmacy hub services.
• Ensure all patient-facing communication channels (calls, chat, email, digital) operate within regulatory requirements.
• Establish compliance frameworks, define escalation protocols, and ensure proper separation between non-clinical staff and licensed pharmacy personnel.
• Partner closely with Clinical Leadership, QA, Drug Safety (AEPC), and Operations to ensure compliant patient interactions.
• Oversee the structure, controls, and performance of compliance monitoring programs for direct call monitoring.

Call Center Compliance Manager – Regulatory Affairs

• Responds to customer inquiries via telephone, email, SMS and Chat to provide problem resolution in accordance with the organization's service standards.
• Receives and/or places telephone calls which are predominantly routine, but may require deviation from standard screens, scripts, and procedures.
• Answer customer telephone inquiries, orders, service needs and complaints, respond where applicable or direct to technical/service areas.
• Maintain detailed and current knowledge of the company's/assigned client's products and services.
• Analyze customer service needs for communication to service and technical departments, when applicable.
• Resolves basic or tier 1 payment and account related requests to include but not limited to card activations, payments, name and address updates for card holders (customers) of 1-2 assigned company clients.
• Provides standardized or scripted responses by utilizing basic user-friendly Graphic User Interface (GUI) screens for client systems and established documentation and processes.
• Enters required data into client provided systems and databases.
• Determines basic reasons for customer issues using a client provided decision tree and escalates or refers unresolved customer grievances and requests to more experienced Customer Service Representatives or designated departments for further investigation and resolution.
• Begins to build base knowledge and familiarization of products, policies, and procedures for a limited number of clients and an understanding of association guidelines and compliance by frequently referring to online manuals and specific client training required to resolve card holder inquiries.

BPS Operations Processing Agent – Call Center

• Act as SME for identity verification and authentication in Branch & Contact Center channels.
• Lead cross-functional coordination.
• Implement CIAM standards and orchestrate authentication flows within commercial banking and payments platforms.
• Define metrics for fraud detection and authentication performance.
• Analyze account takeover and credential compromise trends; develop mitigation strategies.
• Maintain CIAM documentation and strategic roadmap.
• Support annual review and attestation of CIAM capabilities.
• Stay current on B2B and high-value transaction authentication threats and innovations.

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