Customer Care Representative

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Capital Rx

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2017

⚕️ Healthcare Insurance

💳 Fintech

🤖 Artificial Intelligence

Healthcare Insurance • Fintech • Artificial Intelligence

Capital Rx is the fastest growing healthtech company in America, dedicated to transforming the prescription pricing and patient care landscape. Founded in 2017, it offers innovative pharmacy benefit management (PBM) services, including customizable pharmacy benefits for large employers and an AI-powered care navigation platform. Capital Rx focuses on delivering cost-effective solutions and operational efficiencies to clients while ensuring transparency and quality care for patients.

📋 Description

• 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

🎯 Requirements

• 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