Specialist Research

Job Level

Entry Level

Job Summary

The Specialist Research is responsible for researching escalated issues, communicating with members and clients and providing administrative support.  This position is also responsible for meeting established service levels and member expectations.

Job Responsibilities

• Respond to general email box inquiries including monitoring for social media escalations
• Support daily, weekly and monthly reporting requests as needed
• Support SPOC (single point of contact) patients
• Provide clients, members and pharmacies with information regarding benefit plans to assure accurate claims processing and client/member satisfaction research
• Utilize the company’s internal systems to reply to questions and escalated issues from internal and external partners in a timely manner; escalate or re-classify issues as appropriate; communicate issue resolution results per standard operating procedures in a timely manner
• Communicate verbally with clients/members, often de-escalating upset members
• Address escalations within department turnaround time goals
• Other responsibilities as judgment or necessity dictate

Job Responsibilities, continued

Supervisory Responsibilities

N/A

Physical Requirements

• Constantly (67-100% of time OR 6 or more hours) required to sit, use hands to handle or feel, talk and hear
• Frequently (34-66% of time OR 4-6 hours ) required to reach with hands and arms
• Occasionally (0-33% of time OR 1-3 hours) required to stand, walk and stoop, kneel, and crouch
• Occasionally (0-33% of time OR 1-3 hours) required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus
   

Minimum Qualifications

• High school diploma from an accredited school or equivalent GED
   

Additional Qualifications

• Ability to make consistent and unbiased decisions
• Strong organizational, analytical, interpretive, problem solving and time management skills
   

Preferred Qualifications

• Associates's Degree from an accredited school
• Experience in call center or customer service work environment
• Experience in escalation/resolution with successfully applying de-escalation techniques