Schedule Note: The successful candidate must be able to rotate between two weekday shifts (10:00 am - 6:00 pm; 8:00 am - 4:00 pm); and be on call one weekend every 4-6 weeks.
About Us
Top Tier Benefits is a global leader dedicated to revolutionizing benefit management networking by transforming how organizations deliver and optimize employee healthcare solutions. With over twenty years of experience, we partner with employers, insurers, and healthcare providers to deliver streamlined, cost-effective employee healthcare solutions. Our integrated network simplifies prescription access, enhances benefit navigation, and drives measurable savings for organizations and their teams.
Position Overview
We are seeking a Member Care Specialist to provide knowledgeable, efficient, and exceptional service to our members while also supporting key administrative functions. This role is well-suited to individuals who combine excellent communication and relationship-building skills with strong organizational and administrative capabilities. If you are dedicated with a strong customer service background, preferably in pharmacy, we invite you to be part of our mission to provide outstanding healthcare solutions.
Key Responsibilities
- Serve as the first point of contact for member inquiries via phone, email, and chat through a ticketing system.
- Clearly explain healthcare and pharmacy benefits to ensure member understanding.
- Resolve claims, eligibility, and coverage issues with accuracy and professionalism.
- Build and maintain positive relationships with members by delivering timely, proactive support.
- Escalate complex cases when necessary and ensure follow-up to resolution.
- Capture and act on member feedback to help improve overall services.
- Maintain accurate and confidential client records.
- Prepare reports, documents, and member communications.
- Support the development and implementation of client care policies and procedures.
- Collaborate with advisors, insurers, and internal teams to ensure seamless service delivery.
Qualifications
- 2-3 years of experience in pharmacy support role, combined with customer service in related medical environments.
- Demonstrated ability to manage confidential information with discretion and professionalism.
- Strong administrative skills, including documentation, reporting, and record management.
- Excellent verbal and written communication skills with strong attention to detail.
- Proficiency with Microsoft Office, and other administrative tools, including CRM.
Job Type: Full-time
Pay: $22.00-$24.00 per hour
Expected hours: 40 per week
Work Location: In person
