Pharmacy Customer Service Representative

Let’s do great things, together!

About Moda
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.

Position Overview:
Are you a dynamic communicator who thrives in a fast-paced environment?
Join our team as a Pharmacy Customer Services Representative and be a part of an exciting journey in delivering exceptional customer service experiences.

Start Date:
06/02/2025

Please fill out an application on our company page, linked below, to be considered for this position:

https://j.brt.mv/jb.do?reqGK=27754475&refresh=true

Primary Functions:

• Handle a high volume of incoming calls from members, agents, providers, hospitals, pharmacists, Pharmacy Benefit Managers and Mail Order carriers regarding pharmacy benefits or other issues with professionalism and empathy.
• Provide customer service to members of multiple benefit plans by analyzing the caller’s needs and by providing timely and accurate responses.
• Conduct thorough research to ensure accurate responses to complex customer queries.
• Work in a fast-paced environment, adapting to changing customer needs and maintaining a positive attitude all while keeping confidentiality of information for all members by adhering to Moda privacy policies and HIPAA laws and guidelines.
• Exercising good judgment, initiative, and discretion in confidential and sensitive matter.
• Contacts physicians, pharmacies and Pharmacy Benefit Managers when necessary to answer questions and obtain or provide information
• Collaborate with a team of dedicated professionals and follow the guidance of experienced leadership.
• Provide accurate information in a professional manner using current technology and software to document calls from members, providers and other customers in a clear and concise manner.
• Opportunities for professional growth and career advancement.
• Comprehensive training program to equip you with the skills needed for success.
• Supportive and collaborative team environment.

Basic Qualifications:

Required Work Experience

• One-year medical insurance, or other healthcare related field.
• One year call center or customer service.

Education:

• High School Diploma or equivalent
• Proficient computer skills (Type a minimum of 25 wpm & 10-key)
Must be proficient with Microsoft Office applications and able to learn other systems as they pertain to the position

Preferred Qualifications:

• Medical terminology knowledge
• Previous pharmacy experience or knowledge
• Excellent verbal and written communication skills and ability to interact professionally, patiently, and courteously with customers over the phone
• Good analytical, problem solving and decision-making skills
• Ability to work well under pressure with frequent interruptions and shifting priorities
• Ability to come to work on time and be ready to work at the time of assigned shift
• Ability to handle difficult, angry calls and benefit issues with little assistance

Benefits:

• Medical, Dental, Vision, Pharmacy, Life & Disability
• 401K- Matching
• FSA
• Employee Assistance Program
• PTO and Company Paid Holidays
• 401(k) matching
• Dental insurance
• Employee discount
• Flexible spending account
• Health insurance
• Life insurance
• Paid training
• Tuition reimbursement
• Vision insurance
• Work from home

Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training.

For more information regarding accommodations please direct your questions to Kristy Nehler and Danielle Baker via our humanresources@modahealth.com email.