Job Description

Member Services Representative

RxBenefits is hiring! We are adding resources to the Member Services team in our Birmingham, AL headquarters. Member Services Representative I is an important first-line of contact with our customers, setting the tone for how our company and services are experienced. They provide participants with the correct information at the right time to help them make better decisions about their benefits. The Member Services Representative I promotes a positive team environment, continuously evaluating and identifying opportunities to drive process improvements that positively impact the participant experience and aligns to the goals and objectives of the company. Member Services Representative Is use a variety of technological resources to make sure customers receive maximum satisfaction.

The essential job function requires working in an inbound call center environment answering calls professionally and staying focused on building customer loyalty.

Role And Responsibilities

The essential characteristics of this position include excellent communication skills (both written and verbal), the ability to interact and work effectively with co-workers and other departments, wanting to be part of a dynamic team with a positive can-do attitude, and being able to work within tight deadlines. Bilingual (Spanish) is a plus!

Each employee in this classification, depending on assignment, may perform duties that include, but are not limited to, the following:

• Professionally handle a high volume of complex inbound calls
• Ensure questions and issues are resolved from start to resolution, both promptly and accurately and in a manner that the participants can understand while thoroughly and efficiently gathering information, assessing and fulfilling the caller’s needs, and providing education along the way
• Effectively handle complaints while consistently demonstrating behaviors that are respectful and contribute to good service. Must be able to maintain strict confidentiality of sensitive information.
• Work collaboratively with internal and external business partners to provide solutions by taking responsibility for following through and bringing outstanding issues to closure on the initial contact with the participant.
• Address customer issues and ensure effective and long-term problem resolution
• Focus on “call quality” with every call.
• Communicate with other professionals such as various PBM staff, pharmacy staff, pharmacists, medical office staff, and physicians to resolve customer needs.
• Partner with Account Management and Sales Staff to provide customers with excellent service.
• Be a dedicated team member in our phone queue and a great team player with internal colleagues.
• Provide information about company programs, products, and services.
• Learn multiple software systems to be able to service all clients and products

Minimum Qualifications And Requirements

Education:

Associate’s Degree or bachelor’s degree preferred

High school diploma or its equivalent required

Experience:

• Previous call center experience or previous customer service experience within a pharmacy (Pharmacy Technician)
• Pharmacy or PBM experience preferred

Preferred Knowledge/Skills/Abilities:

• Prior Member Services knowledge with a concentration in pharmacy experience preferred
• Ability to identify process improvements
• Excellent interpersonal skills for frequent interaction with members, managers, brokers, and vendors.
• High degree of professionalism, with ability to interact effectively with employees at all levels
• Excellent written and oral communication skills required
• Must demonstrate passion and enthusiasm
• Knowledgeable in principals and protocols of phone etiquette and call center techniques
• Excellent verbal and written communication skills
• Proficiency with Microsoft Office products including Word and Excel, the Internet, Outlook email
• Demonstrates strong Member Services focus
• Self-motivated, self-starter, with a positive personality
• Good decision-making ability and problem-solving skills
• Ability to work for extended periods of time wearing a headset in a call center environment
• Ability to read, understand and adhere to standard company policies and procedures
• Sensitive to confidential information
• This position will require the applicant to be available during the hours of the customer support center.

Demonstrated Knowledge and Skills:

• Proficient in business English, spelling, punctuation and grammar
• Demonstrate proficiency in Microsoft Office products and Internet navigation
• Ability to communicate in a clear, concise, understandable manner, and listen attentively to others
• Ability to provide outstanding Member Services to a diverse customer base
• Ability to remain positive in all situations with difficult customers.
• Ability to handle non-routine customer calls
• Ability to sell a product or service
• Ability to adjust priorities and manage time wisely in a fast-paced environment
• Ability to gather data, monitor processes, and seek continuous improvement opportunities

Preferences:

• Knowledge of pharmacy and pharmacy benefit processes
• Strong organizational skills and extremely detail-oriented
• Ability to use good judgment and discretion
• Ability to work with multiple interruptions and tight deadlines
• Past relationship customer experience a plus
• Performance Assessment
• On a consistent basis, random agent calls and other communications (email, customer contacts), both inbound and outbound, will be monitored and recorded to assess the level of customer satisfaction.

Measurement:

Performance expectations will be assessed based on the following measurements:

• Average number of calls handled or other communications processed
• Average handle time
• Call/Communication quality
• Attendance and punctuality
• Proficiency in all phases of work
• Superior performance will be based on consistently exceeding our quality standards, the ability to solve customer concerns quickly, accuracy in call processing and related tasks, and having a flawless attendance record.
• The scheduled operating hours for Member Services are 7:00 am to 8:00 pm, Monday through Friday (subject to change based on operational need).

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