November 2012 — Present
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Field Training Specialist
Handle customer service inquiries from members, providers, physicians and internal and external clients related to pharmacy benefits. Work to research and resolve problems in a timely manner. Assist members in understanding and maximizing the use of their pharmacy distribution program. Use computerized system to gather information and respond to questions. Document issues and resolutions in a common database. Escalate issues as necessary.
Handle inbound and outbound member, provider and physician calls. Answer questions related to pharmacy benefits, while maintaining productivity standards and performance guarantees where applicable.
Work with other operational departments to research and resolve mail order and claims issues and respond to members within performance agreement guidelines.
Maintain accurate and complete documentation of all inquiries in order to continuously improve the customer service process and reduce potential legal concerns.
Identify and escalate in a prudent manner, concerns received from patients and/or clients so that corrective action can be pursued and expedited to take care of their needs.
Credentialed medical providers' and allied health providers' information into system from different states and clients' employment applications. Followed state laws and the regulatory standards such as NCQA, JCAHO, URAC.
Handled incoming calls from our clients' employees
Call center environment
Provided solutions to healthcare benefits, 401(k) savings, life insurance, retirement plans, payroll, leaves of absence, and HR issues
Navigated through series of databases to access appropriate information
Prioritized customer urgency
Provided follow through for resolutions
Assisted store manager with shipping/receiving of new products
Processed necessary paperwork
Maintained appropriate inventory levels
Provided training for new employees and helped set goals
Responsible for maintenance of stock room
Responsible for inbound/outbound phone calls to patients and physicians
Resolved outstanding issues or questions regarding prescription orders
Served as emergency after hours on-call coordinator
Worked on inside sales projects and Synagis project
Provided outstanding customer service skills