[Hiring] Customer Service Specialist @Healthesystems

Role Description

The role of the Customer Service Specialist is to build trusted relationships with our clients, their claimants, and pharmacies by providing superior customer service to every caller.

• Works with Team Lead, Supervisor, and Manager to resolve phone inquiries related to claims adjudication, eligibility verification, prior authorization, and other Pharmacy Benefit Management, Ancillary Benefits Management, and some Billing Verification Department functions as required.
• Utilizes strong verbal and written communication, listening and organizational skills, as well as strong problem-solving and reasoning skills to accomplish this.
• Demonstrates ability to adhere to attendance, punctuality, and quality guidelines including flexibility to work varying or rotating shifts, including overtime, weekends, and holidays as necessary.
• Demonstrates ability to read prescription drug names, comprehend simple instructions, and write short correspondence/memos as well as translate jargon and complex processes into simple, step-by-step instructions.
• Demonstrates attention to detail, ability to work in an ever-changing workflow environment, patience, professionalism, and compassion while handling difficult customers and situations.
• Shows flexibility and a customized approach in meeting all types of member communication styles and personalities.
• Takes initiative and assumes responsibility where appropriate.

Qualifications

• High school diploma or general education degree (GED) and one to two years related customer service and/or healthcare experience required; or equivalent combination of education and experience.

Requirements

• Knowledge of Windows-based applications as well as the ability to multi-task with dual monitors and swiftly enter information using keyboard is required.
• Prior experience in an administrative business environment is highly preferred.
• Experience in the healthcare industry is preferred.
• To facilitate working from home, candidates must provide their own reliable, high-speed internet access with sufficient bandwidth to execute all job functions.
• Candidates must provide a private workspace free from distraction and noise.
• Company laptop will be provided.

Benefits

• Competitive compensation and benefits package including healthcare coverage, PTO, paid holidays, 401(k), company-provided life insurance/disability coverage, wellness options, and more.
• Pay is based on several factors including but not limited to education, work experience, certifications, geographical cost of labor, etc.
• Healthesystems offers a comprehensive benefits package including health, dental, vision, disability and life insurance, wellness resources, recognition programs, 401k contribution, and PTO & Holiday pay (all subject to eligibility requirements).
• Applicable statutory benefits also provided, including the Colorado HFWA.