CLIENT SERVICES ASSOCIATE (Pharmacy Benefits)

RxBenefits is seeking a highly organized and motivated individual to join the Client Service team as Client Service Associate. As a Client Service Associate your focus is to support Clients, EBCs, and Account Managers so they can easily navigate through any questions or issues that come up in their day-to-day processes. The essential job function requires working in a fast past environment answering inbound and executing outbound calls and emails in a professional manner while staying focused on providing accurate and complete information and solutions for our customers. The Client Services Department promotes a positive team environment, continuously evaluating and identifying opportunities to drive process improvements that positively impact the participant experience and aligns to the goals and objectives of the company.

Job Responsibilities Include:

• Manage individual case load to ensure timely responses to all requests according to company standards
• Test issues and analyze information to determine if client changes are needed
• Participate in training opportunities to ensure sharing of knowledge and processes with internal team members
• Review setup documents to track and research issues to confirm client intent and to help with issue resolution
• Address any questions that may arise with enrollment or eligibility information with appropriate contacts
• Working knowledge and thorough understanding of eligibility requirements and benefits for assigned clients
• Identify any potential quality issues per defined process and escalate potential quality issues immediately to management.
• Communicate frequently/promptly with manager/director regarding problems encountered in the unit
• Work with external PBM partners when necessary to resolve client/member issues
• Ability to coordinate with multiple functional areas including Client Onboarding, Account Management, Data Operations, Member Services, Management, etc.
• Analyze complex problems and interpret client materials appropriately.
• Train on PBM reporting systems and stay educated on all forms and processes each PBM has for implementing new groups and making changes to existing groups
• Reconcile eligibility discrepancies, analyze transactional data and submitting retroactive eligibility changes
• Communicate effectively with leadership for escalated issues
• Work collaboratively with internal and external business partners to provide solutions by taking responsibility for following through and bringing outstanding issues to closure
• Assumes additional responsibilities as prescribed or directed

Required Skills / Experience:

• 2+ years of Member or Client Service experience
• 5 years of related pharmacy work experience preferred
• Must have strong organizational, leadership abilities and multi-tasking skills
• Ability to make both routine and difficult decisions in a fast-paced, high stress environment
• Pharmacy/Healthcare related experience preferred
• Excellent interpersonal skills for frequent interaction with members, managers, and vendors.
• Excellent written and verbal communication skills required
• Two years of college preferred