Consumer Service Operations Rep

Become a part of our caring community and help us put health first
Responsible for the ongoing coordination of all client care, delivery on ongoing therapies and communication with case management agencies. Other responsibilities include initial intake of client referrals, coordination of billing with all insurance plans and the fulfillment of medication regimens.
Location: Onsite New Hyde Park, New York
Hours: Monday-Friday 9AM to 5:30PM. Possibility for overtime as needed.
ESSENTIAL DUTIES AND RESPONSIBILITIES
TECHNICAL SKILLS

• Proficient in current technology system(s) to perform the following tasks: Enter patient admissions, change an active patient to discharge/deceased status, transfer patients, update demographic changes, process refills and documentation as needed.
• Proficient in the prescription entry process.
• Proficient in Third Party Rejection Processing
• Ongoing maintenance of all established patients
• Coordinate with pharmacy, delivery of medication and supplies in a timely manner.
• Coordinates communication related to client admissions, discharge and change in status.
• Performs intake of initial client referrals including collection of client demographic information, medical information, therapy information and insurance/financial information and documentation on the "Referral Form".
• Assists pharmacists in the preparation of vial prescriptions and CIM blister packs.
• Prepares and generates batch for preparation oral medications.
• Organizes assigned workload to facilitate its accomplishment.
• Other duties as assigned by manager

EFFECTIVE TRIAGE & PROBLEM-SOLVING SKILLS

• Triage incoming calls generated by patients or providers and forward higher complexity and clinical-based concerns to the CIM Pharmacist.
• Proactively notify patient and providers of delay in medication arrival.
• Assist in obtaining refill requests from providers on behalf of the client.
• Assign and schedule consultations and refill reminders.
• Assist with faxing provider consultations which have been completed.
• Follow up on patient/provider outreaches to determine and document outcomes.
• Provide suggestions for system enhancements and to improved process and productivity.
• Ability to respond to high volume inbound calls in a timely and effective manner.

QUANTITY OF WORK

• Produces quantity of work that is above the documented average.

PROFESSIONAL INTERACTION

• Provide superior customer service to our clients.
• Demonstrates excellent verbal and written communication with fellow associates, clients and healthcare providers.
• Demonstrates a caring, ethical and professional behavior when interacting with associates, clients and caregivers.

Use your skills to make an impact
QUALIFICATIONS

• Excellent verbal and written communication skills.
• Self-motivated.
• Ability to manage multiple priorities.
• Team player.
• Problem-solver
• Ability to follow through on assigned tasks.
• Possess unquestionable personal and professional ethics.
• Adaptable to change in systems and practice environment.

EDUCATION AND/OR EXPERIENCE

• Customer service experience
• Recent pharmacy technician experience
• Call center experience
• Community pharmacy experience where MTM was offered (Preferred).

COMPUTER SKILLS

• Proficient in general Microsoft office.
• General Windows-based computer skills.
• Strong typing skills with a minimum of 20 wpm.

CERTIFICATES, LICENSES & REGISTRATIONS (preferred)

• Active pharmacy technician license in good standing in New York (preferred)
• Pharmacy Technician Certification Board (PTCB) Certification (preferred)

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee will be required to sit, perform repetitive physical and mental activities, have face-to-face and telephone contact with individuals or teams, have telephone conversations, write letters and memos, use electronic mail, meet strict deadlines, work with others in a group or team, and work with external customers or the public. Job tasks are performed in close physical proximity to other people. The employee must occasionally lift and/or move up to 15 pounds. Specific vision abilities include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
WORK ENVIRONMENT:
Work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
POSITION TYPE / EXPECTED HOURS OF WORK

• This is a full-time, non-exempt position.

Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$44,600 - $61,250
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Us
About Enclara: Pharmacia Enclara Pharmacia is the nation's largest full-service hospice and palliative care Pharmacy Benefits Manager, offering compassionate and cost-effective services to our most vulnerable patients. As a wholly owned subsidiary of Humana, Enclara works closely with hospice providers to reduce pharmacy costs, improve patient care and support caregivers through digital innovations, flexible medication access, one-on-one clinical support and excellent customer service.
About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of Humanato take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.