Servicing Representative

. Act as a customer advocate by answering phone calls, written correspondence and servicing walk-in members in a timely fashion .

Posted 9/25/2026full-timeBuffalo • New York • United StatesJunior💰 $20 per hourWebsite

Key responsibilities & impact

Act as a customer advocate by answering phone calls, written correspondence and servicing walk-in members in a timely fashion
De-escalate customers and resolve customer complaints
Provide accurate and up-to-date information on policies and procedures and communicate successful resolutions
Ensure compliance with all CMS rules and regulations
Log all contacts into appropriate systems
Meet or exceed quality, productivity and accuracy goals measured by the representative’s scorecard
Maintain technical knowledge regarding Pharmacy Benefit Dimensions’ contracts, benefits, policies and procedures
Attend required training sessions as needed
Document pertinent information into appropriate systems to meet NCQA, state and CMS standards
Address first-level complaints and provide assistance on appeals as needed
Resolve written inquiries regarding claims, benefits, eligibility, reimbursement and participating providers
Coordinate the use of multiple systems and training manuals simultaneously
Perform other duties as required, including walk-in member servicing, correspondence support and outbound calls

What you’ll need

High school diploma or GED required
Associate degree preferred
Six (6) months of experience working for a health insurance company, physician’s office or pharmacy required
Experience handling self-funded pharmacy calls preferred
Experience in a call center operations environment preferred
Ability to effectively communicate with internal and external customers
Excellent written and verbal communication skills
Excellent customer service skills
Experience handling high volume, inbound and outbound phone calls preferred
Ability to listen with intent to understand
Proficient in verbally translating written communication
Typing 35-40 words per minute required
Proficient in problem solving with the ability to prioritize accordingly
Ability to utilize multiple system tools simultaneously
Strong organizational and time management skills
Proven examples of displaying the PBD values: Trusted Advisor, Innovative, Excellence, Guardianship, Dedication and Caring
Immigration or work visa sponsorship will not be provided for this position

Comp & perks