Customer Service Representative (CSR) – Healthcare Operations

Diverse Lynx is seeking a Customer Service Representative for healthcare operations. The role resolves pharmacy order-related issues through outbound calls to patients and healthcare providers, customer service, and back-office administrative work.

Responsibilities:

• Make outbound calls to patients and healthcare providers to resolve pharmacy order issues and provide updates
• Perform back-office administrative tasks related to pharmacy orders, documentation, and issue resolution
• Deliver excellent customer service while handling routine inquiries and escalated calls professionally
• Address issues related to medication delivery arrangements, payments, clinical information requirements, and required consultations
• Maintain a working knowledge of health plan benefits, provider networks, applicable CMS regulations, and healthcare partner policies
• Review and update customer information, document interactions, and maintain accurate records in relevant systems
• Use sound judgment to prioritize tasks, investigate concerns, and implement appropriate resolutions
• Follow established procedures, quality standards, privacy requirements, and compliance guidelines
• Collaborate with internal teams and healthcare providers to ensure timely resolution of outstanding issues
• Perform other related duties as assigned

Requirements:

• High school diploma or GED equivalent; higher education is acceptable
• At least 2 years of combined or related experience in healthcare, call center operations, or customer service
• Experience using a telephone and computer as primary tools for performing job responsibilities
• Proficiency in Microsoft Office applications, including:
• Microsoft Word: Creating and maintaining documents
• Microsoft Excel: Creating and maintaining spreadsheets
• Microsoft Outlook: Managing email communications and calendars
• Strong verbal and written communication skills
• Excellent problem-solving, multitasking, and organizational abilities
• Ability to handle sensitive information professionally and maintain confidentiality
• Associate degree or higher in healthcare or a related field
• Knowledge of medical terminology
• Familiarity with ICD-9, ICD-10, and CPT coding systems
• Previous experience in pharmacy services, medical billing, health insurance, or healthcare customer support
• Experience handling patient inquiries, provider communications, and healthcare-related administrative processes