Customer Care Associate II

Customer Care Associate II

Our work matters. We help people get the medicine they need to feel better and live well. It fuels our passion and drives every decision we make. This position is a frontline service position providing assistance to members and providers regarding programs, policies, and procedures. Responsibilities include answering incoming calls related to eligibility, benefits, claims and authorization of services from members or providers. Responsibilities also include the administration of intake documentation into the appropriate systems. Overall expectations are to provide outstanding service to internal and external customers and strive to resolve member and provider needs on the first call. Performance expectations are to meet or exceed operations production and quality standards.

Responsibilities

Listens and probes callers to determine purpose of the calls.

Researches and communicates information regarding member eligibility, benefits, and claim status.

Resolves customer administrative concerns.

Assists in mentoring and training of new staff.

Assumes full responsibility for self-development and career progression.

Assembles and enters patient information into the appropriate delivery system.

Demonstrates flexibility in job duties and schedule.

Educates providers on how to submit claims.

Identifies and responds to crisis calls.

Informs providers and members on appeal process.

Leads or participates in activities to improve Care Center performance.

Links or makes routine referrals and triage decisions.

Performs necessary follow-up tasks.

Provides information regarding reimbursement rates.

Refers callers requesting provider information.

Refers patients to the Care Management team.

Updates self on ever-changing information.

Supports team members and participates in team activities.

Documents customer comments and information.

Minimum Qualifications

High school diploma or GED required.

Two years of experience in customer service.

Must be eligible to work in the United States.

Additional Qualifications

Must be flexible in scheduling and comfortable with change.

Must meet call handling requirements and daily telephone standards.

Must agree to observing service for training and quality control.

Must be a proficient typist with strong written and verbal communication skills.

Must be able to maneuver through various computer platforms.

Must be able to talk and type simultaneously.

Preferred Qualifications

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures. Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.

Potential pay for this position ranges from $19.23 - $28.85 based on experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law. We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law. Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email Careers@primetherapeutics.com.