Independent Health Assoc., Inc.
Member Services Specialist- EGWP (Finance)
The Member Services Specialist-EGWP (Specialist) is a customer service professional who has experience with and a strong understanding of Medicare rules and regulations, displays confidence, has a passion for service, and practices empathetic listening towards all Pharmacy Benefit Dimensions (PBD) customers.... The Specialist functions as an advocate for all customers and resolves all inquiries (i.e. phone, mail, fax and email.)... They will utilize system tools and resources to address and resolve inquiries; provide benefit clarification and eligibility; communicate claim and reimbursement information, facilitate proper utilization of policies and procedures, coordinate resolution to streamline processes; make demographic changes; and educate customers on regulatory policies and procedures.... The Specialist will also work with the Supervisor, Servicing, to ensure Medicare process accuracy and standard compliance for the Member Services team and will serve as the Medicare subject matter expert (SME) for the Pharmacy Service Technicians (PST).
Qualifications
Key Accountabilities
A. Servicing
o Productivity goals - measure Representative.........s ability to be productive and use time effectively and efficiently. Includes average talk plus hold time, after call work (ACW), adherence, use of non-available states, tardiness and attendance.
o Accuracy goals - measure Representative.........s ability to respond to inquiries correctly and accurately.
B. Technical Proficiency
C. Administrative Duties
As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant.........s race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law. Click here for additional EEO/AAP or Reasonable Accommodation information.
Current Associates must apply internally via their Career Worklet.