Exemption Status:

United States of America (Non-Exempt)

$16.47 - $20.80 - $25.13

“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Summary:

Works as a member of the Customer Service team. Provide customer service to all members, providers, facilities, clients, and brokers with all aspects of benefits, eligibility, and claim status inquires in accordance with the plan documents, policies, procedures and administrative guidelines.   

Essential Duties and Responsibilities

• The ability to maintain a courteous and professional demeanor while working under pressure, the ability to work independently and as part of a team, detail oriented, excellent data entry,10 key, bilingual a plus.
• Convey a positive image of the company by promptly responding to customer phone inquiries and determining the appropriate actions to resolve issues, gather and provide information, and offer assistance.
• Deliver service that meets or exceeds department performance standards for Average Hold Time, Abandonment Rate, Talk Time, Quality, Adherence, and One-touch Resolution.
• Utilize multiple company database programs to research and resolve complex issues relating to benefit information, claims adjudication, eligibility verification, prior authorization, and other TPA processes. Use task route function, Quickbase, and other processes & tools as applicable to escalate issues, request follow up action, or obtain assistance from other areas of the organization as necessary.
• Educate external customers about Verdegard’s roles and responsibilities. Provide information about benefit benefits, prior authorization requirements, grievance and appeal processes, and other TPA functions as specified by health plan sponsors in online CS Notes.
• Follow up with callers as appropriate to ensure customer satisfaction and timely response to requests. Diffuse upset customers by appropriately listening to issues, calming the customer, and providing positive solutions to resolve concerns.
• Represent Verdegard in a positive manner by adhering to processes and established procedures and guidelines. Support the department strategy by delivering Customer Service Excellence through telephone courtesy, prompt response to callers, anticipation of customer needs and concerns, solution-oriented problem solving, greetings, and call closing messages.

Client Responsibilities

This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written).  One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience        

High school diploma or general education diploma (GED) or equivalent. A minimum 2 years’ related experience; or equivalent combination of education and experience. Experience in health care is a plus but not required. Excelle