Pharmacy Customer Service Representative

in Tampa
, FL
Reference: 19-02650

Job Summary: 

  • Responds to member and provider inquiries (phone, written or walk in) regarding all aspects of  business, including claims, in a professional, timely, accurate and caring manner while consistently meeting all guidelines

Key Duties and Responsibilities:

  • Responds to member, provider and other inquiries via telephone, correspondence or lobby walk-in while meeting all corporate guidelines and performance standards
  • Demonstrates appropriate customer-care skills such as empathy, active listening, courtesy, politeness, helpfulness and other skills as identified
  • Records, investigates and resolves member complaints as detailed in the Grievance Procedure narrative
  • Assists in the education of new members and in the re-education of existing members regarding health plan procedures
  • Logs, tracks and appropriately documents all issues utilizing on-line systems and procedures. and in accordance with all applicable guidelines and requirements
  • Makes decisions that are consistent with the concept of a win-win-win for members and associates
  • Demonstrates based behaviors such as initiative, accountability, and value
  • Performs skills necessary to create a high-quality customer experience, as reflected through acceptable C-Sat scores, quality monitors and member feedback


  • A High School or GED required
  • Or equivalent work experience required

Work Experience:

  • 6 months of experience in relevant work required
  • Other previous experience in a call center or customer service environment preferred

Licenses and Certifications:

  • Other Customer service, quality or training certifications preferred


  • Demonstrated written communication skills
  • Demonstrated interpersonal/verbal communication skills
  • Ability to multi-task, good organizational and time management skills
  • Demonstrated organizational skills
  • Demonstrated time management and priority setting skills
  • Ability to effectively present information and respond to questions from peers and management
  • Ability to create, review and interpret treatment plans
  • Ability to act on feedback provided by showing ownership of his or her own development
  • Ability to read, analyze, and interpret verbal and written instructions
  • Seeks to build trust, respect and credibility with all partners through full, honest, consistent, and coordinated communication
  • Ability to define problems, collect data, establish facts and draw valid conclusions


  • Microsoft Outlook
  • Microsoft Word
  • Microsoft Excel