Pharmacy Provider Relations Representative
New
CanadaFull-TimeMiddle
Salary not disclosed
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Job Details
- Required Skills
- Data AnalysisMicrosoft ExcelCustomer service
Requirements
- Previous experience in customer service, preferably in a call centre or healthcare-related environment.
- Strong communication and interpersonal skills with a professional and empathetic telephone manner.
- Proficiency in Microsoft Office applications, particularly Word and Excel.
- Ability to analyze information, troubleshoot issues, and resolve complex inquiries independently.
- Familiarity with pharmacy, dental, or medical terminology is considered a strong asset.
- High attention to detail, strong organizational skills, and ability to work in a fast-paced environment.
- Proven ability to take ownership of issues and deliver accurate information consistently.
- Strong commitment to delivering excellent customer service and continuous learning.
Responsibilities
- Respond to inbound inquiries from healthcare providers regarding benefit eligibility, plan coverage, prior approvals, claim status, and submission requirements.
- Verify and process claims using online adjudication and claims management systems.
- Accurately document all provider interactions and ensure proper logging of call details and outcomes.
- Investigate and resolve complex inquiries by conducting research and analyzing claim or eligibility data.
- Provide feedback and insights to management to support workflow improvements and service enhancements.
- Assist in supporting operational projects using tools such as Microsoft Excel and Word for reporting and analysis.
- Maintain high-quality customer service while ensuring compliance with organizational policies and procedures.
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