Job Closed

This listing is no longer active.

Southern Scripts logo
Southern Scripts

Liviniti, LLC provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or genetics. In addition to federal law requirements, Liviniti, LLC complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. Liviniti, LLC expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Liviniti, LLC employees to perform their job duties may result in discipline up to and including discharge. EOE M/F/D/V

Clinical Member Services Agent

Location

United States

Posted

78 days ago

Salary

0

Seniority

Mid Level

No structured requirement data.

Job Description

Clinical Member Services Agent

Southern Scripts

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The clinical member services agent (CMSA) is responsible for providing effective customer service for all internal and external customers by using excellent, in-depth knowledge of company products and programs as well as communicating effectively with team members within the clinical department. The CMSA will work in conjunction with the member service agent to assist in clinical situations and resolutions. - Knowledge of principles and processes for providing customer and personal services, including customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction. - Confer with customers by telephone to provide information about Rx claims processing. - Understanding of Pharmacy terms and formularies as a certified Pharmacy Technician (CPhT). - Keep detailed records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken. - Follow-up to ensure that appropriate changes were made to resolve customers' problems. - Refer unresolved customer grievances to designated departments for further investigation. - Review Rx insurance policy terms to determine whether a claim is covered for employer group. - Contact customers to respond to inquiries or to notify them of claim investigation results or any planned adjustments. - Resolve customers' service or billing complaints. - Obtain and examine all relevant information to assess validity of complaints and to determine possible causes. - Abide by all obligations under HIPAA related to Protected Health Information (PHI). - If a HIPAA violation is discovered, report the violation to the Compliance Officer and/or Human Resources. - Attend, complete, and demonstrate competency in all required HIPAA Training offered by the company. - Flexibility to understand, appreciate and embrace that this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Qualifications - High School or equivalent. - Customer service experience. - Certified Pharmacy Technician Certification (CPhT) with experience in a pharmacy setting. - Computer experience. Requirements - Interacting with Computers — Using computers and computer systems (including hardware and software) to program, write software, set up functions, enter data, or process information. - Communicating with Supervisors, Peers, or Subordinates — Providing information to supervisors, co-workers, and subordinates by telephone, in written form, e-mail, or in person. - Getting Information — Observing, receiving, and otherwise obtaining information from all relevant sources. - Communicating with Persons Outside Organization — Communicating with people outside the organization, representing the organization to customers, the public, government, and other external sources. - Processing Information — Compiling, coding, categorizing, calculating, tabulating, auditing, or verifying information or data. - Resolving Conflicts and Negotiating with Others — Handling complaints, settling disputes, and resolving grievances and conflicts. - Updating and Using Relevant Knowledge — Keeping up-to-date technically and applying new knowledge to your job. - Organizing, Planning, and Prioritizing Work — Developing specific goals and plans to prioritize, organize, and accomplish your work. - Performing Administrative Activities — Performing day-to-day administrative tasks such as maintaining information files and processing paperwork. - Making Decisions and Solving Problems — Analyzing information and evaluating results to choose the best solution and solve problems. - Customer and Client Focus. - Problem Solving and Analysis. - Time Management. - Communication Proficiency. - Teamwork Orientation. - Technical Capacity. - Multitasking. - Competencies as a Certified Pharmacy Technician (CPhT). Benefits - Medical, Dental, Vision Insurance - Disability and Life Insurance - Employee Assistance Program - Remote work options - Generous Paid-Time Off - Annual Reviews and Development Plans - Retirement Plan with company match, immediately 100% vested Position Type and Expected Hours of Work This is a full-time, hourly position. Days and hours of work vary on shift assigned. The Call Center hours of operation are Monday – Friday 6a – 10p, Saturday 8a – 6p, and Sunday 8a-5p. On-Call responsibilities are on a rotation basis. This position reports to the Contact Center Supervisor. Travel Minimal travel expected for this position to Natchitoches, Louisiana for training and development.

Job Requirements

  • High School or equivalent.
  • Customer service experience.
  • Certified Pharmacy Technician Certification (CPhT) with experience in a pharmacy setting.
  • Computer experience.
  • Interacting with Computers — Using computers and computer systems (including hardware and software) to program, write software, set up functions, enter data, or process information.
  • Communicating with Supervisors, Peers, or Subordinates — Providing information to supervisors, co-workers, and subordinates by telephone, in written form, e-mail, or in person.
  • Getting Information — Observing, receiving, and otherwise obtaining information from all relevant sources.
  • Communicating with Persons Outside Organization — Communicating with people outside the organization, representing the organization to customers, the public, government, and other external sources.
  • Processing Information — Compiling, coding, categorizing, calculating, tabulating, auditing, or verifying information or data.
  • Resolving Conflicts and Negotiating with Others — Handling complaints, settling disputes, and resolving grievances and conflicts.
  • Updating and Using Relevant Knowledge — Keeping up-to-date technically and applying new knowledge to your job.
  • Organizing, Planning, and Prioritizing Work — Developing specific goals and plans to prioritize, organize, and accomplish your work.
  • Performing Administrative Activities — Performing day-to-day administrative tasks such as maintaining information files and processing paperwork.
  • Making Decisions and Solving Problems — Analyzing information and evaluating results to choose the best solution and solve problems.
  • Customer and Client Focus.
  • Problem Solving and Analysis.
  • Time Management.
  • Communication Proficiency.
  • Teamwork Orientation.
  • Technical Capacity.
  • Multitasking.
  • Competencies as a Certified Pharmacy Technician (CPhT).

Benefits

  • Medical, Dental, Vision Insurance
  • Disability and Life Insurance
  • Employee Assistance Program
  • Remote work options
  • Generous Paid-Time Off
  • Annual Reviews and Development Plans
  • Retirement Plan with company match, immediately 100% vested
  • Position Type and Expected Hours of Work
  • This is a full-time, hourly position. Days and hours of work vary on shift assigned. The Call Center hours of operation are Monday – Friday 6a – 10p, Saturday 8a – 6p, and Sunday 8a-5p. On-Call responsibilities are on a rotation basis. This position reports to the Contact Center Supervisor.
  • Travel
  • Minimal travel expected for this position to Natchitoches, Louisiana for training and development.

Related Job Pages

More Customer Support Jobs

OtherRemoteTeam 51-200

Description Join an Amazing Team at Davinci Virtual! Davinci Virtual is the leading global provider of business addresses, live answering services, and meeting spaces. We’re a fast-growing, fulfillment-driven company known for our innovative solutions and exceptional service—and we’re looking for friendly, energetic people to join our team! As a Virtual Client Specialist, you are the voice of our company. You’ll handle inbound calls on behalf of Davinci’s clients while providing warm, professional, top-notch customer support. After completing in-person training at our Midvale office, you’ll work fully from home—no commute, no dress code, all comfort. (You’ll just need reliable internet and a quiet workspace.) If you're enthusiastic, customer-focused, and excited about growing with an incredible team, this may be the perfect fit for you! What We Offer: Competitive Pay & Bonuses • $16/hr. to start • New-hire bonuses at 3 months and 9 months • Lots of opportunity for advancement Exceptional Benefits (Seriously Amazing!) • 100% employer-paid Medical, Dental, and Vision for employees • Affordable family plans • HSA, FSA, and Dependent Care FSA options • Employer-paid life insurance, short-term disability, and long-term disability Rewards & Recognition Program – Nectar Earn points from peers, leaders, and HR that you can redeem for: • Bonuses added to your paycheck • Extra paid time off • Amazon items or gift cards Work-From-Home Flexibility • After training, work fully remote • Supportive team and leadership • Opportunities for professional development and leadership training What You'll Do: • Answer inbound calls accurately, efficiently, and with a great attitude • Provide outstanding customer service on every call • Navigate client instructions, websites, schedules, and tools with confidence • Send professional, well-written emails as needed • Meet call quality, accuracy, and answer-time standards • Communicate effectively with coworkers, leaders, and clients • Review team stats daily and strive to meet goals • Follow department procedures, policies, and workflows • Contribute to team culture and be a positive, supportive teammate Grow With Us – Professional Development: • Participate in leadership and personal development programs • Bring forward ideas to improve processes and the customer experience • Commit to achieving team and company goals • Continuously learn new tools and skills Requirements What You Need: • High School diploma • 40+ WPM typing speed • Excellent written and verbal English skills • Customer service experience • Proficiency with Microsoft Office, Outlook, Internet, and Windows • Reliable high-speed internet for WFH • Backup location in case of outages (or ability to work occasionally from our office) Preferred Traits: • Team player with strong communication • Problem-solving and conflict-resolution skills • Motivated, tech-savvy, and eager to learn • Organized, focused, and adaptable • Consistent and dependable attendance • Professional presentation Working Conditions • Quiet, distraction-free home workspace • Frequent use of phone and computer systems • Must be able to sit at a desk for most of the shift • Minimal physical effort required All job offers are contingent upon passing a background check, including verification of past employment, education, and criminal records as permitted by law.

United States
Job Closed
Global Elite Empire Consultants logo

Work From Home - Client Benefits Specialis

Global Elite Empire Consultants

Good Grief is focused on building a competitive remote sales team.

Customer Support78 days ago
OtherRemoteTeam 2-10

Are you a passionate individual seeking a fulfilling career that offers flexibility and growth opportunities? Look no further! With the option to work from home and enjoy a flexible schedule, you can balance your personal and professional life seamlessly while advancing your career. Perks Include: 1. Work-Life Balance: Embrace the freedom to work from home and tailor your schedule to fit your lifestyle, ensuring you have time for what matters most to you. 2. Supportive Environment: Join a nurturing community that values work-life harmony and provides the support and flexibility you need to thrive in your career. 3. Mentorship & Growth: Access mentorship opportunities from experienced leaders who are dedicated to helping you succeed, empowering you to grow and excel in your role. Qualifications: • Dedication to delivering exceptional customer service experiences. • Strong communication and interpersonal skills. • Ability to lead and inspire teams to achieve outstanding results. • Desire to pursue professional growth and development while maintaining a healthy work-life balance. If you’re ready to embark on a fulfilling career path that offers flexibility, growth, and support, apply now! Take advantage of this opportunity to work from home, enjoy a schedule that suits your lifestyle, and receive mentorship as you advance your career in client service leadership. Don’t miss out on this chance to prioritize both your personal and professional aspirations. Apply today and take the next step towards a rewarding career! *All interviews will be conducted via Zoom video conferencing (Global Elite Empire Consultants is a third-party recruiter, not an insurance agency)

United States
Job Closed
OtherRemoteTeam 1,001-5,000Since 1887H1B No Sponsor

Member Service Coordinator Location: Dallas, TX (remote). What Our Member Service Coordinators Do and Why It’s Important: Member Service Coordinators provide exceptional customer service, supporting participants through their company’s wellness program and addressing any inquiries or concerns related to our wellness initiatives. Additionally, this role is the forefront of our advocacy services, helping members navigate their benefits and ensuring they receive the support they need. Core Activities of the Job Include: - Answering all questions related to HealthCheck360 products, services, and programs through phone, email and chat - Assisting with tasks that may include processing Physician’s Screening Forms, participant outreaches, printing or binding, and other special projects. - Providing feedback and presenting solutions to improve efficiencies and the participant experience - Support advocacy services to help members understand and utilize their benefits effectively. Schedule: The standard work week for this position will be Monday through Friday, 8-5pm. Strengths and Skills Necessary for Success in the Role: - For this role, we are looking for several key characteristics that will be necessary to succeed in the position: positive, team-oriented, solution focused, highly organized and even-keeled. About Cottingham and Butler’s Health and Wellness Division Cottingham and Butler’s Health and Wellness division was created with the employer's needs and the participant's experience in mind. We focus on reducing medical costs, while increasing employee engagement and productivity. This is accomplished by providing onsite biometric screenings, engaging participants through technology and programming, educating the participant with risk-specific targeted communications, and supporting positive behavior change through our Health Coaching and Condition Management programs. Want to learn more? Follow us on www.CottinghamButler.com | LinkedIn | Facebook

United States
Job Closed
OtherRemoteTeam 10,001+H1B Sponsor

Anticipated End Date: 2026-03-19 Position Title: Customer Care Representative I Job Description: Customer Care Representative I Location: Virtual; This role enables associates to work virtually full-tine, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office Please note that per our policy on hybrid/virtual/ work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law Hours: Monday - Friday, an 8 hour shift between 8:00 am - 8:00 pm EST. The Customer Care Representative is responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. How will you make an impact: - Responds to internal and external customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims. - Analyzes problems and provides information/solutions. - Operates a PC/image station to obtain and extract information; documents information, activities and changes in the database. - Thoroughly documents inquiry outcomes for accurate tracking and analysis. - Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner. - Researches and analyzes data to address operational challenges and customer service issues. - Provides external and internal customers with requested information. - Under immediate supervision, receives and places follow-up telephone calls / e-mails to answer customer questions that are routine in nature. - Uses computerized systems for tracking, information gathering and troubleshooting. - Outbound calls are conducted in the ZipDrug business area. Minimum Requirements: - Requires a HS diploma or equivalent and previous experience in an automated customer service environment; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities and Qualifications: - For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. - Experience in a high-volume call center environment is strongly preferred. Job Level: Non-Management Non-Exempt Workshift: Job Family: CUS > Care Reps Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

United States
Job Closed