Customer Care Representative I Location: This is a virtual position. Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Hours of Operation: Monday - Sunday, 8 am - 8 pm EST. Weekend schedules only from October 1st to March 31st of each year during peak season. The Customer Care Representative I is responsible for acting as a trusted advisor and educator on inquiries such as coverage for medications and prior authorizations. How you will make an impact: Responds to internal and external customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims. Analyzes problems and provides information/solutions. Operates a PC/image station to obtain and extract information; documents information, activities and changes in the database. Thoroughly documents inquiry outcomes for accurate tracking and analysis. Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner. Researches and analyzes data to address operational challenges and customer service issues. Provides external and internal customers with requested information. Under immediate supervision, receives and places follow-up telephone calls and fax to answer customer questions that are routine in nature. Uses computerized systems for tracking, information gathering and troubleshooting. Outbound calls are conducted in the ZipDrug business area. Minimum Requirements: Requires a HS diploma or equivalent and previous experience in an automated customer service environment; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities & Experiences: Healthcare Experience Pharmacy Experience Call Center Experience For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
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