Customer Service Representatives

Job Responsibilities:

• Answer inbound and make outbound calls to members in a courteous and professional manner.
• Conduct medical pre-qualification screenings by verifying patient information, medical conditions, and prescription eligibility according to program guidelines.
• Accurately document all patient interactions, responses, and relevant details in the system while maintaining strict confidentiality and HIPAA compliance.
• Collaborate with internal teams to ensure smooth handoff to licensed agents or pharmacy staff when necessary.
• Maintain up-to-date knowledge of products, compliance requirements, and campaign changes to relay accurate information to patients.
• Meet or exceed daily performance metrics, including call handling time, quality assurance scores, and conversion rates.

Job Qualifications:

• BPO experience is preferred but not required.
• Strong verbal and written communication skills.
• Background in healthcare administration, finance, customer service, or a related field is a plus.
• Tech-savvy and adaptable to new systems and tools.
• Willing to work onsite, including weekends and holidays.
• Handle patient concerns with empathy, patience, and professionalism, escalating complex issues to supervisors as needed.