Member Care Representative -Remote- MCR West
Description:
Looking for something BETTER? So were we! Thats why TrueScripts was created. But better didnt stop there. Thats why were now looking for YOU!
What Were About
If you are an A Player looking for a new challenge, a fulfilling career, and a family-based values company, we welcome the opportunity to meet with you. TrueScripts is a Prescription Benefits Management (PBM) company. We manage prescription plans for self-insured businesses.
A potential candidates values must match our TrueScripts business core values of Integrity, Respect, Innovation, and Service an inherent trait to always provide a high level of Service. This match in value systems is critical for our team's chemistry and continued success. Our culture is positive, and our people possess a can do, proactive attitude staying out in front of the curve so that we can best advise our clients of the ever-changing world in prescription management.
Honesty and transparency are the foundation that we build upon. What sets us apart from our competitors is the programs that we bring, the education that we provide, and the utmost respect for clients and their members to assist them when and where needed.
Our team members enjoy:
Robust benefits and a strong salary
ESOP - Team Member Owned
Employee Assistance Program
Wellness Program
Dream Manager Program (yes, its a real thing!)
A cohesive, family-based culture
Charitable contributions
Lots of celebrations!
Ok, enough about us. Heres what we need from you:
What youll do
In a few words
Member Care Representative is responsible for performing all tasks relative to in-house and external communications with TrueScripts clients and members. Response to member and client inquiries assists members with appropriate prescription benefits, and the problem solves any issues in the claims system. Provides administrative support to Clinical Care, Account Management & Executive teams. Most importantly-Provide amazing care to those who call and need our help and/or service.
The fundamentals for the job
Account Inquiries & Claims Processing
Receive phone calls/emails from members, clients, pharmacies, and/or physician offices
Troubleshoot claim processing problems and/or inquiries in the claims adjudication system
Respond to website inquiries
Become proficient in all aspects of the claims adjudication system
Communicates problems and concerns to the manager
Clinical Care Support
Complete new/renewal Prior Authorization requests for specialty & non-specialty drugs
Reach out to members to assist in a change of Rx to a more cost-effective generic alternative
Assist members needing copay assistance for brand medications
Create/mail Brand Care letters
Account Support
QA testing for client transitions/changes
Complete the pharmacy contact sheet for fax notifications
Performs other duties as assigned
Requirements:
What youre made of
The bold requirements
Customer service experience
Knowledge of claims processing helpful
Analytical thinking and attention to detail
Excellent communication and customer relations skills
Problem-solving skills
Ability to multi-task and prioritize in an ever-changing environment
Strong computer skills including Microsoft Office (Excel, Word, PowerPoint, Outlook)
High School Diploma and/or college degree in a related field preferred
Pharmacy technician experience preferred, not required
* To be considered for this role, applicants must reside in Pacific time zone.
Apply Now
Looking for something BETTER? So were we! Thats why TrueScripts was created. But better didnt stop there. Thats why were now looking for YOU!
What Were About
If you are an A Player looking for a new challenge, a fulfilling career, and a family-based values company, we welcome the opportunity to meet with you. TrueScripts is a Prescription Benefits Management (PBM) company. We manage prescription plans for self-insured businesses.
A potential candidates values must match our TrueScripts business core values of Integrity, Respect, Innovation, and Service an inherent trait to always provide a high level of Service. This match in value systems is critical for our team's chemistry and continued success. Our culture is positive, and our people possess a can do, proactive attitude staying out in front of the curve so that we can best advise our clients of the ever-changing world in prescription management.
Honesty and transparency are the foundation that we build upon. What sets us apart from our competitors is the programs that we bring, the education that we provide, and the utmost respect for clients and their members to assist them when and where needed.
Our team members enjoy:
Robust benefits and a strong salary
ESOP - Team Member Owned
Employee Assistance Program
Wellness Program
Dream Manager Program (yes, its a real thing!)
A cohesive, family-based culture
Charitable contributions
Lots of celebrations!
Ok, enough about us. Heres what we need from you:
What youll do
In a few words
Member Care Representative is responsible for performing all tasks relative to in-house and external communications with TrueScripts clients and members. Response to member and client inquiries assists members with appropriate prescription benefits, and the problem solves any issues in the claims system. Provides administrative support to Clinical Care, Account Management & Executive teams. Most importantly-Provide amazing care to those who call and need our help and/or service.
The fundamentals for the job
Account Inquiries & Claims Processing
Receive phone calls/emails from members, clients, pharmacies, and/or physician offices
Troubleshoot claim processing problems and/or inquiries in the claims adjudication system
Respond to website inquiries
Become proficient in all aspects of the claims adjudication system
Communicates problems and concerns to the manager
Clinical Care Support
Complete new/renewal Prior Authorization requests for specialty & non-specialty drugs
Reach out to members to assist in a change of Rx to a more cost-effective generic alternative
Assist members needing copay assistance for brand medications
Create/mail Brand Care letters
Account Support
QA testing for client transitions/changes
Complete the pharmacy contact sheet for fax notifications
Performs other duties as assigned
Requirements:
What youre made of
The bold requirements
Customer service experience
Knowledge of claims processing helpful
Analytical thinking and attention to detail
Excellent communication and customer relations skills
Problem-solving skills
Ability to multi-task and prioritize in an ever-changing environment
Strong computer skills including Microsoft Office (Excel, Word, PowerPoint, Outlook)
High School Diploma and/or college degree in a related field preferred
Pharmacy technician experience preferred, not required
* To be considered for this role, applicants must reside in Pacific time zone.
Apply Now