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Client Services Specialist II - Agent Services Call Center

  • Tennessee, Franklin

  • 02/19/2026

  • Contract

  • Active

Job Description:

  • Job Summary  
    We are seeking a detail-oriented and customer-focused Customer Service Representative to support Medicare and pharmacy-related inquiries. This role involves handling inbound and outbound calls, assisting with prior authorizations and appeals, and providing guidance on prescription drug benefits. The position requires strong communication skills, healthcare insurance knowledge, and the ability to thrive in a fast-paced environment.

    Key Responsibilities
    1. Handle inbound and outbound calls related to Medicare and pharmacy benefits.
    2. Assist with prior authorizations, appeals, and reimbursement inquiries.
    3. Explain prescription drug coverage and benefit structures clearly to customers.
    4. Document all interactions accurately in CRM/case management systems.
    5. Coordinate with internal teams, agents, and program partners to resolve issues.
    6. Manage multiple cases simultaneously in a fast-paced environment.
    7. Provide guidance and support to agents and customers.
    8. Ensure compliance with company policies and program guidelines.

    Required Qualifications
    1. High School Diploma or GED.
    2. 1–3 years of customer service experience, preferably in healthcare.
    3. Strong verbal and written communication skills.
    4. Ability to multitask and manage multiple systems effectively.
    5. Detail-oriented with strong documentation skills.

    Preferred Qualifications
    1. Experience with Medicare (Part A/B/C/D) and/or PBM/pharmacy benefits.
    2. of prior authorizations, appeals, or insurance verification processes.
    3. Experience with CRM tools such as Salesforce, NaviNet, or payer portals.
    4. Call center or phone-based support experience.

    Top Skills for Success
    1. Prescription drug reimbursement and insurance knowledge.
    2. Strong customer service and communication abilities.
    3. Multitasking, organization, and systems navigation skills.

    Work Environment & Physical Requirements
    1. Onsite work environment (3 days per week required).
    2. Ability to sit or stand for extended periods (7–10 hours/day).
    3. Occasional lifting (up to 25 lbs).
    4. Must be able to use standard office equipment and systems.

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