Pharmacy Customer Service Representative
$38,251–$42,806 year
On-siteMilwaukie, Oregon, United States
Job Summary
Respond to member and provider inquiries regarding pharmacy benefits, eligibility, and claims via telephone, virtual platforms, or in person. Analyze caller needs to confirm coverage, explain plan details, and resolve escalated situations involving drug information and claim adjustments. Apply mathematical skills to determine correct benefit data, review revised regulations, and request necessary claim corrections. Maintain departmental service standards by providing timely follow-ups, recording complaints and appeals, and consulting with leadership on complex cases. Work in a fast-paced environment requiring proficiency with multiple computer programs and the ability to adapt to shifting priorities.
Required Qualifications
- High school education or equivalent experience
- 1-2 years in a fast-paced customer service environment
- A pharmacy or insurance setting preferred
- Type a minimum of 25-wpm on a computer keyboard
- Ability to apply mathematical skills to provide and determine correct benefit information
- Proficient with Microsoft Office Applications, including Word and Excel and Outlook
- Strong verbal, written, and interpersonal communication skills
- Ability to interact professionally, patiently, and courteously with customers over the phone, in virtual meeting platforms and in person
- Proficiency in working thoughtfully and appropriately with a culturally, linguistically and ability diverse population
- Ability to work well under pressure
- Ability to work with frequent interruptions, shifting priorities and quickly adapt to change
- Ability to work independently and as part of a team
- Ability to anticipate, meet and/or exceed customer needs and expectations in a professional manner
- Ability to come to work on time and on daily basis
- Maintain confidentiality and project a professional business image
- Ability to meet or exceed department standards and deadlines
- Ability to multitask and efficiently utilize multiple (7-8) computer programs and packages at the same time
- A reliable, high-speed, hard-wired internet connection required to support remote or hybrid work
- Must be comfortable being on camera for virtual training and meetings
- Work in excess of standard workweek, including evenings and occasional weekends, to meet business need
Desired Qualifications
- A pharmacy or insurance setting preferred
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