This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Member / Provider Services Representatives ("MSRs" / "PSRs") are the front-line team at Capital BlueCross ("CBC") and are responsible for handling all customer inquiries through multiple channels (i.e., phone, web, electronic, and/or face-to-face) by using resources, materials, and tools with accuracy and precision. - Effectively present and discuss our products and services. - Create and maintain positive relationships. - Exceed quality, productivity, and ultimate performance goals. - Attend extensive training classes and ongoing periodic refresher trainings. Qualifications - Must possess basic reading and arithmetic skills (reading and math comprehension). - Must possess above average verbal and written communication skills. - Demonstrated competency in computer programs such as internet browsers, Microsoft Outlook, Word, Excel, PowerPoint, etc. - Ability to present a positive and cooperative attitude via multi-channel connections with customers. - Ability to deliver 'delightful' and effective customer service. - Ability to actively listen and demonstrate empathy for customers. - Strong attention to detail and interest in preventing errors. - Ability to effectively de-escalate upset callers with minimal supervisory intervention. - Ability to thrive in a dynamic working environment, multi-task, and adapt quickly. - Strong work ethic and passion for products and customer experiences. - Foster an inclusive culture of diversity. - Capacity to up-sell and speak highly of products and company. Requirements - 1 year of customer service experience. - Recent tele-commuting experience a plus. - Must have a High School Diploma or GED. - College degree or professional certification (Medical Assistant, Certified Professional Coder, Pharmacy Technician) a plus. - Bi-lingual (Spanish) a plus. - License to sell (a plus, may be required for advanced positions). Benefits - Comprehensive benefits package including Medical, Dental & Vision coverage. - Retirement Plan. - Generous time off including Paid Time Off, Holidays, and Volunteer time off. - Incentive Plan. - Tuition Reimbursement. Work Environment - Call Center environment. - Flexible to work any varied shift schedules that may span anywhere between 8:00 a.m. to 8:00 p.m. - Schedule includes weekend and holiday hours. - Minimum Internet Service Provider (ISP) speed requirements for work at home: Approximately 15Mbps download and 5Mbps upload. - Latency (PING) under 150ms; satellite internet is typically not sufficient for real-time communication. Physical Demands - Frequently required to sit, use hands and fingers, talk, hear, and see. - Must be able to work over 40 hours per week. - Occasionally lift and/or move up to 5 pounds. Key Interfaces - Salesforce - Facets - Bridges - Workflow - Microsoft Office (Outlook, Word, Excel, PowerPoint) - Availity - NICE InContact - Workbench - Prime RxClaims - TruCare

The vision of Clinical Health Network for Transformation (CHN) is to support the mission and promise of Planned Parenthood to bring high-quality, affordable care to every member of our communities. CHN is a collaboration between Planned Parenthood affiliates across the United States. CHN is looking for individuals who are committed to supporting our shared goal of strengthening and enhancing our awareness and commitment to advancing the cause of health equity in our organization. An abortion patient navigator is a community health professional that focuses on the abortion patient’s needs to access care on both an individual basis, and at a systems level. The patient navigator helps guide the patient through the abortion care system and works to overcome obstacles faced by the patient receiving the care and services they require, while working to improve the systems and processes that shape access at the clinical and ecosystem levels. The patient navigator will help patients identify needs and connect patients to appropriate resources and supports. The navigator may be involved and coordinate with outside entities as well. The patient may have needs to arrange legal counsel, transportation and travel logistics, dependent care or anything else necessary to help them obtain their abortion that the patient navigator will assist with. The patient navigator collaborates with diverse organizations and personnel to ensure the needs of the patient are met. Essential Functions - Organizing schedules and managing appointments for patients to ensure they receive services in a timely manner and at a location most convenient for them based on the patient’s clinical care site preferences - Able to provide effective case-management to a varying caseload of patients - Facilitating communication between the patient, support person(s) and/or organization(s), and healthcare providers to ensure patient satisfaction and quality of care - Monitoring multiple mediums of communication for referral intake by conducting calls, answering emails and responding to chats - Collect and organize patient data, draft correspondence, and make financial and/or travel commitments to callers on behalf of CHN’s Patient Navigation program - De-escalate situations and offering excellent, patient-centered customer service - Informing the patient on financial aspects of care and linking the patient to financial resources and local affiliate patient navigators - Helping patients plan and book trips including but not limited to arranging and booking flights, bus, train, rideshares and making reservations for overnight accommodations - Guide patients through troubleshooting, navigating the network of abortion resources, their travel and using the products or services patient navigation offers - Working closely with affiliate and contact center staff, including but not limited to social workers, Fund managers and counselors, contact center staff, health center managers, and others to create efficiencies and improve workflows for increased abortion access and improved patient experience - Facilitating pre and post-abortion visits and ensuring continuity of care and linkage to affiliate resources - Creates and promotes a culture of continuous improvement - Ensures compliance with all CHN and affiliate policies, as well as all state and federal regulations - Demonstrates a commitment to CHN and Planned Parenthood’s mission related to health equity, especially centering racial equity, and deep sense of accountability to community - Demonstrates a commitment to learning about and enhancing practices related to racial equity and the impact of structural racism on healthcare systems - Provides positive and development feedback and accountability related to practices including, but not limited to, equity The above duties and responsibilities are not an exhaustive list of required responsibilities, duties, and skills. Other duties may be added, and this job description can be amended at any time. Qualifications and Experience (Required) - Bachelor’s degree in public health, social work or related area, or 3 relevant years' experience in healthcare administration, public health, social work, counseling, or a related field - Experience and/or training in trauma-informed care, abortion access, case management, and/or program management a plus - Willingness to travel in accordance with the needs of the position. Compliance with all CHN travel policies, including safety guidelines while operating a personal vehicle. - Attention to detail and accuracy in critical work - Excellent written and verbal communication skills in alignment with Customer Service expectations; positive interface with patients - Strong organizational and computer skills, including MS Word, MS Excel and health care administrative software (EMR/EHR). - Effective problem-solving skills, critical thinking, and ability to multi-task. - Must be an effective time manager - Must have integrity, energy, and enthusiasm - Accepts a flexible work schedule including weekend and evening hours as necessary Qualifications and Experience (Preferred) - EPIC Experience - Experience working with or for Planned Parenthood - Knowledge of abortion landscape - Understands United States geography and time zones - Commercial travel knowledge Key Requirements - Commitment to advancing race(+) equity in one’s work: interested in expanding knowledge about the role that racial inequity plays in our society - Awareness of multiple group identities and their dynamics, bringing a high level of self-awareness about personal identity, empathy, and humility to interpersonal interactions - Demonstrated ability to communicate clearly and directly as well as hear and act on feedback related to identity and equity with the aim to learn - Strong sense of accountability to equitable practices - Understanding of the impact of identity dynamics on organizational culture - Commitment to CHN and Planned Parenthood’s In This Together service ethos, workplace values, and service standards $24 - $35 an hour CHN believes in fair and equitable pay. Above is the pay range for this role. Please note that actual salaries may vary within the range, based on factors including, but not limited to, education, training, experience, professional achievement, and business need. CHN provides employees with a competitive benefits package; some highlights include the following: - Health Care Coverage (Medical, Dental, & Vision); eligibility for full-time, regular employees on date of hire - Flexible Spending Accounts and Health Savings Account - Short-Term Disability and Basic Life & AD&D Insurance provided by CHN - Voluntary elections for Long Term Disability and Additional Life & AD&D Insurance available at cost - Employee Assistance Program - Retirement Plan, 3% employer match after one year of service - Paid Time Off Program includes accrual-based PTO, Health Time Off (HTO), and nine (9) paid Holidays Clinical Health Network for Transformation (CHN) is an equal employment opportunity employer. We comply with all applicable laws prohibiting discrimination based on race, color, religion, gender and gender expression/identity, age, ethnicity, national origin, ancestry, physical or mental disability, uniformed service member/veteran status, marital status, medical condition, pregnancy, sexual orientation, citizenship status, genetic information, as well as any other category protected by federal, state, or local. We are committed to building an inclusive workplace that values racial & social justice. We strongly encourage all persons to apply, including members from all racial and ethnic groups and members of the LGBTQIA+ community.

Company : Highmark Inc.Job Description : JOB SUMMARY Perform accurate and timely processing of pre-certification requests for authorization of medically necessary health care services at the appropriate level of care, based on the benefits for the line of business, and in compliance with the organization's policies, procedures and regulatory requirements. Document, process and route requests for services to the nurse reviewer and other departments based on documentation procedures, including review type, clinical information, and decision timeframes. Follow policies and procedures to assure case completion and compliance with state and federal regulatory agencies. Maintain or exceed department standards for call volume, response time and related production and quality measures. May interact with other departments and providers to resolve cases. ESSENTIAL RESPONSIBILITIES: - Communicate effectively - Proactively inform designated individuals of the status of work assignment to assure decision timeframes and notification requirements are met - Communicate effectively with Utilization Management Staff, providers, other internal and external customers and management - Route Cases Based on Established Guidelines - Provide accurate and timely routing of service requests to the nurse reviewer to assure that the decision and notification timeframes are in compliance with regulatory guidelines - Process service requests meeting established guidelines, and document and route requests that are not permitted - Request additional information verbally and in writing when the information provided is not adequate to make a medical necessity determination - Maintain or exceed department call center standards - Adhere to line of business phone standards to assure regulatory requirements are met - Utilize phone functions to monitor the number of calls in queue and wait time - Utilize daily phone standard reports to assess opportunities for self improvement - Meet or exceed standards for other production and quality measures - Other duties as assigned or requested. QUALIFICATIONS Preferred - High School Diploma / GED - Experience in customer service - Experience in typing, keyboard and computer skills - Work experience in medical terminology - Associates degree or certification in a health related occupation - Work experience with ICD-9 and/or CPT coding Language (Other than English): None Travel Requirement: 0% - 25% PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS Position Type Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. Pay Range Minimum: $19.27 Pay Range Maximum: $27.42 Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Accredo is hiring Customer Service Representatives. Start date: April 20, 2026 Training Schedule: Monday - Friday, 8:00 am - 4:30 pm CST for 6-8 weeks (No absences during training) Post-Training Schedule: Monday - Friday 11:00 am - 8:00 pm EST Transform healthcare and contribute to our industry-leading organization as a Customer Service Representative. Our Customer Service Representatives are dedicated team members who excel at customer service, helping us elevate our Patient Care to new heights. In this crucial role, you are on the front lines with patients, responding to phone inquiries and addressing each with care, detail, and most importantly, empathy. Here’s a little more on how you’ll make a difference: - Help patients understand their pharmacy benefits better. Use the knowledge you gain from training, your problem-solving skills and support from your team answer patient calls effectively. - Help us keep track of our patient interactions. While on calls, use your expert listening skills to get to the heart of a patient’s question quickly and document all interactions in real-time. - Ensure patients are equipped with the best advice. Identify and empathetically address patient concerns and, if necessary, escalate appropriately. What You Should Have: - High School Diploma / GED required - 1+ years of customer service/call center experience - General PC knowledge including Microsoft Office Suite - Excellent communication skills (verbal and written) - Experience with RXHome, and Care Central or Customer Relationship Manager preferred. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an hourly rate of 17.75 - 19 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.