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- Develop and maintain working knowledge of current products and services offered by the company and Pharmacy products.
- Answer all calls and emails in a timely manner, in adherence to their goals
- Document all call information according to standard operating procedures
- Answer questions about products and services, retail stores, general service line information and other information as necessary based on customer call needs
- Process orders, route calls to appropriate resource, and follow up on customer calls where necessary
- Review all required documentation to ensure accuracy
- Accurately process, verify, and/or submit documentation and orders
- Complete insurance verification to determine patient's eligibility
- Must be able to navigate through multiple online EMR systems to obtain applicable documentation
- Responsible for contacting patient when documentation received does not meet payer guidelines to provide updates and offer additional options to facilitate the referral process.
- Meet quality assurance requirements and other key performance metrics
- Facilitate resolution on customer complaints and problem solving
- Pays attention to detail and has great organizational skills
- Actively listens to patients and handle stressful situations with compassion and empathy
- Flexible with the actual work and the hours of operation
- Excellent customer service skills
- Analytical and problem-solving skills with attention to detail
- Decision Making
- Excellent ability to communicate both verbally and in writing
- Ability to prioritize and manage multiple tasks
- Proficient computer skills and knowledge of Microsoft Office
- Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction
- General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred.
- Work well independently and as part of a group
- Ability to adapt and be flexible in a rapidly changing Pharmacy environment, be patient, accountable, proactive, take initiative and work effectively on a team
- High School Diploma or equivalent
- One (1) year work related experience in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry.
- Exact job experience is considered any of the above tasks in a Medicare certified.
Customer Service Specialist - Murray, United States - AdaptHealth
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