Customer Care Representative (Full-Time)

About Judi Health

Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:

• Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
• Judi Health™, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
• Judi®, the industry’s leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.

Together with our clients, we’re rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit www.judi.health.

Position Responsibilities

• Efficiently triage incoming phone calls with professional phone etiquette from members and pharmacies with minimal support. Ask probing questions to identify and resolve all issues and address concerns promptly
• Provide support for call center staff, including other technicians and customer service representatives
• Identify, accurately document, and escalate member and pharmacy concerns to the appropriate internal team including various members of the Operations Team
• Effectively communicate issues and solutions to members, pharmacies, and relevant internal stakeholders to ensure customers receive quality care and that the resolution meets all health and safety standards
• Communicate effectively with internal and external customers to provide first-call resolution and de-escalate customer concerns
• Ensure customer satisfaction, extraordinary customer care, and quality resolution with genuine compassion in a fast-paced, environment
• Follow all internal Standard Operating Procedures and adhere to HIPAA guidelines and Company policies
• Support the Fraud, Waste, and Abuse program by reviewing pharmacy claims information and communicating findings to appropriate internal staff
• Work with multiple systems, up to 2 monitors, and multitask in a fast-paced environment
• Self-starter who displays a positive attitude, strong work ethic, and excellent attendance
• Meet all departmental goals including schedule adherence, attendance, and quality monitoring
• Standard hours for training: Monday thru Friday, 9:00am – 5:30pm, Eastern
• Perform other customer support duties as assigned
• Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance

Required Qualifications

• High school diploma or the equivalent; Associates or Bachelor’s degree preferred
• 2+ years of customer service, call center, and/or health care experience with a passion for building customer loyalty through exceptional listening, relationship building, and strong written and verbal communication preferred
• 2+ years of PBM or related Health Care experience required
• Ability to work independently with minimal supervision, stay productive in a remote, high-volume, fast-paced, metric-driven call center environment
• Bilingual Spanish highly preferred
• Medicare experience preferred

Hourly Rate: $26.00

This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at https://www.judi.health/legal/privacy-policy.