Customer Care Representative

This is a fully remote position, open to applicants in United States.

📋 Description

• Efficiently manage incoming phone calls with a professional demeanor from members and pharmacies while requiring minimal support. Utilize probing questions to identify and resolve issues and address concerns in a timely manner.

• Offer assistance to call center personnel, including fellow technicians and customer service representatives.

• Identify, meticulously document, and escalate concerns from members and pharmacies to the appropriate internal teams, including various members of the Operations Team.

• Clearly communicate issues and solutions to members, pharmacies, and relevant internal stakeholders to guarantee quality care and that resolutions comply with health and safety standards.

• Engage effectively with both internal and external customers to achieve first-call resolution and to de-escalate customer concerns.

• Ensure customer satisfaction, provide exceptional care, and deliver quality resolutions with genuine empathy in a fast-paced environment.

• Adhere to all internal Standard Operating Procedures while following HIPAA guidelines and Company policies.

• Assist the Fraud, Waste, and Abuse program by examining pharmacy claims information and reporting findings to the relevant internal staff.

• Navigate multiple systems, utilizing up to two monitors, and multitask efficiently in a high-pressure environment.

• Self-motivated individual who exhibits a positive attitude, strong work ethic, and excellent attendance record.

• Achieve all departmental objectives, including schedule adherence, attendance, and quality monitoring.

• Standard training hours are Monday through Friday, from 9:00 AM to 5:30 PM Eastern.

• Perform additional customer support responsibilities as assigned.

• Responsible for compliance with the Capital Rx Code of Conduct, including reporting noncompliance.

⛳️ Requirements

• High school diploma or equivalent; an Associate's or Bachelor's degree is preferred.

• A minimum of 2 years in customer service, call center, and/or healthcare experience, with a commitment to fostering customer loyalty through exceptional listening, relationship building, and strong written and verbal communication skills is preferred.

• At least 2 years of experience in PBM or a related healthcare field is required.

• Capability to work independently with minimal supervision while maintaining productivity in a remote, high-volume, fast-paced, metric-driven call center environment.

• Bilingual in Spanish is highly preferred.

• Experience with Medicare is preferred.

🏝️ Benefits

• Comprehensive health benefits package.

• Opportunities for professional development and career advancement.

• Flexible work environment.

• Supportive team culture.