About Judi Health
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:
- Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
- Judi Health™, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
- Judi®, the industry’s leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.
Together with our clients, we’re rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve.
Position Responsibilities
- 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.
- Meet all departmental goals including schedule adherence, attendance, and quality monitoring.
- Perform other customer support duties as assigned.
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.
- 2+ years of PBM or related Health Care experience required.
- Ability to work independently with minimal supervision in a remote, high-volume, fast-paced, metric-driven call center environment.
- Bilingual Spanish highly preferred.
- Medicare experience preferred.