Customer Resolution Associate

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

📋 Description

• Process, document, communicate, and track member cases for Pharmacy Services.

• Engage with members, pharmacies, prescribers, and plans to offer support and assistance with program inquiries and administrative tasks.

• Manage inbound and outbound communication via phone, email, and fax related to the concierge program.

• Handle Pharmacy case management by entering, reviewing, and documenting requests in claims processing and case management systems.

• Create and maintain case profiles while accurately entering member, prescriber, pharmacy, and drug information.

• Investigate and resolve telephone inquiries promptly and escalate issues as needed.

• Oversee work queues and volumes to meet specific client turnaround times.

• Perform additional duties as assigned.

⛳️ Requirements

• A high school diploma from an accredited institution or an equivalent GED.

• Must be authorized to work in the United States without requiring a work visa or residency sponsorship.

• Excellent verbal and written communication skills, strong interpersonal abilities, and a keen attention to detail.

• Proven organizational and time-management capabilities.

• Eagerness and ability to learn internal systems, processes, and programs.

• Availability to work overtime, weekends, and holidays on a rotating basis as needed.

• Ability to adapt and collaborate effectively in a fast-paced, dynamic production environment.

• Basic math skills and familiarity with general PC knowledge, including Microsoft Office, the Internet, and email.

• Flexibility to work a schedule that meets business needs.

• Preferred: An associate's degree in business, health care, or a related field of study.

• Preferred: One year of customer service experience, including at least six months in Pharmacy Benefit Management (PBM) or health care.

• Must adhere to security responsibilities, security controls, legal, regulatory, contractual obligations, and internal policies and procedures.

• Must be capable of performing the essential functions of the role.

🏝️ Benefits

• A variety of benefits, incentives, and additional compensation are available; please refer to the Benefits at a glance page.

• Reasonable accommodations for employees with disabilities will be provided, barring undue hardship.

• We are an equal opportunity and affirmative action employer.

• Our workplace is tobacco-free.