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Convey Health Solutions Customer Service Representative in Yuma, Arizona

This job was posted by : For more information, please see: Job DescriptionReceive inbound calls from health plan members enrolled into a Medicare Advantage or Medicaid program. Assist members with updating account information, providing OTC benefit information, resolving issues, and taking new orders or reorders via mail or telephone for OTC products approved by the plan ESSENTIAL DUTIES AND RESPONSIBILITIESUpdate account information such as temporary changes of address for shipping or alternate phone numbers. Educate members on how the supplemental OTC benefit works, including benefit amounts, and products available, and frequencey of coverage. Identify member complaints and grievances and escalate according to client specific procedures.Assist health plan members with inquiries related to their OTC benefits and/or orders placed. Process requests for OTC items received from health plan members via mail or phone call Look up over-the-counter medicines on the formulary to verify if they are offered, and if a drug is not offered provide an explanation as to why. Make concise and detailed notations as it pertains to member records. Communicate with coworkers, management, staff, customers, and others in a courteous and professional manner. Conform with and abide by all regulations, policies, work procedures and instructions. Respond promptly when returning telephone calls and replying to correspondence and faxes. Act, dress, and behave in a professional manner to reflect a positive image of the company. OTHER DUTIES AND RESPONSIBILITIES Responsible for compliance with all federal, state and local laws, rules and regulations affecting Company.Responsible for participating in quality assurance, compliance and in-service and continuing education activities as requested by Company.Responsible for performing other duties and responsibilities as required. Knowledge, Skills, and Abilities: Ability to provide clear and accurate information and follow up when necessary Strong attention to detail. Ability to solve problems - identifies and resolves problems in a timely manner, gather and analyze information skillfully, develop alternative solutions, work well in group problem solving situations, and use reason even when dealing with emotional topics. Requires technical skills - Assess own strengths and weaknesses, pursue training and development opportunities, strive to continuously build knowledge and skills, and share expertise with others. Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine correspondence. Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. Skill in dealing politely, tactfully and firmly with a wide range of people and personalities. Skill in communication and interpersonal skills sufficient to exchange or convey informationand to receive work direction. Skill in organizing and prioritizing tasks. Knowledge of business English grammar, spelling and composition. Knowledge of business etiquette. Must be able to operate computer, calculator, copier, fax machine, phone and other o ffice equipment. Must be able to multi-task and think quickly. Ability to communicate well orally and in writing in the English language. Ability to understand and carry out complex oral and written instructions. Ability to interact professionally and maintain effective working relationships with superiors, coworkers, customers, and others. Ability to work in an environment with many interruptions. Ability to be flexible and juggle many assignments or projects at the same time. Working efficiently in a stressful environment.