Customer Care Representative (Full-Time)

About Judi Health Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single, secure platform. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels. At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we all deserve. We are the intelligence platform powering benefits plans for millions of Americans and proudly leading the next generation of care. To learn more, visit www.judi.health . Location : Remote Position Responsibilities : Efficiently triage incoming phone calls with professional phone etiquette from members pharmacies, and providers with minimal support. Ask probing questions to identify and resolve all issues and address concerns promptly Identify, accurately document, and escalate member, pharmacy, and medical claims concerns to the appropriate internal team including various members of the Operations Team Effectively communicate issues and solutions to members, pharmacies, providers 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 and medical 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 Required Qualifications : 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 medical claims 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 Hourly Rate: $26.00 This range represents the low and high end of the anticipated base salary range. The actual base salary will depend on several factors such as: experience, knowledge, skills, and location of the job. Remote, US Salary Range $26 — $26 USD All employees are responsible for adherence to the Judi Health Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals. We provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at https://www.judi.health/legal/privacy-policy .