Customer Service Representative

Company Profile:
Maximus Canada is an industry leader in the provisioning of products and services to support the delivery of government services in North America and internationally. With operations across Canada and around the globe, Maximus provides innovative, practical and meaningful solutions to help government programs and services function more effectively and efficiently.

We are constantly assessing new technology, processes and methods of delivering services to the citizens of Canada. With our expertise in program information management, claims processing, contact centre services, document processing and information technology, we are positioned for significant growth.

Maximus Canada offers competitive market-based salaries, comprehensive employer-paid benefits and a defined-benefit pension plan or a Group RSP with employer-matching contributions, for eligible employees. Our people also get some great perks too, such as employee appreciation events throughout the year, along with a supportive results-oriented work environment.

**Job Description**:
**Department Summary**

On behalf of the B.C. government, Health Insurance BC (HIBC) administers medical coverage through the Medical Services Plan (MSP) and drug coverage through the PharmaCare and Fair PharmaCare programs. With a staff of ~180 unionized employees and 3 excluded managers, the HIBC Operations department delivers services measured by 20 SLRs and 29 SLOs via four teams:

- Customer Service (PharmaCare Help Desk, Service Desk, Info Support, and Prosthetics and Orthotics)
- Document Operations (Document Management, Document Processing, Admin Review, and Correspondence Liaison Unit)
- Practitioner and Patient Services (Provider Programs, Benefit Services, Billing Support, and In Province and Out of Country Adjudication)
- Operational Support Services (Medical Services and Pharmaceutical Services Support, Production Control, Support Coordinators)

**Key Responsibilities**

Help Desk CSRs spend their day answering calls from pharmacists who have questions related to our provincial pharmaceutical system - PharmaCare. Our telephone system queues and monitors thousands of calls per month, therefore CSRs are expected to meet call handling targets.

As the “face” of HIBC, CSRs will handle all calls pleasantly and professionally, even those that are more difficult in nature. Depending on the work shift and business need, this position also processes pharmaceutical claims that are mailed in.
- Answer and complete provider calls within 2:30 minutes to meet our Average Speed of Answer SLR of less than 1 minute
- Process documents provided providers, via HIBC forms and correspondence, to meet our SLO of 90 % documents processed within 20 business days
- Understand and comply to MAXIMUS Canada, legislated and client policies and work procedures accurately, 98% of the time to meet our Quality SLR and to provide excellent customer service
- Adhere to your work commitment and daily schedule 95% of the time so that MAXIMUS Canada can meet its business goals efficiently and reliably
- Manage your interactions with callers, clients and colleagues respectfully, collaboratively and professionally to contribute to a harmonious, productive work environment

**Education and Experience**
- Proficient knowledge of MS Office, Outlook, ability to operate standard office equipment
- Call centre experience preferred
- Fair Pharmacare experience an asset
- Must be able to work alone

Understand the Principles of:

- Call control and customer situational judgment
- Customer service
- Excellent and professional verbal & written communication skills
- Professional, pro-social inter-relations
- Privacy and security of personal information

**Knowledge, Skills and Abilities**

Systems Use (B=basic I=intermediate A=advanced, E=expert)

MS Office Suite: I MaxPath: B Verint: B Cisco: I MaxImage: I RAPID: I Client Registry: B

Answer provider calls
- Verify callers and validate the information they provide
- Articulate PharmaCare program policies and procedures clearly, neutrally, and quickly
- Review account information and drug history to determine the correct response to a caller’s enquiry
- Calculate deductible amounts
- Update IT systems, as appropriate
- Troubleshoot provider connectivity problems and escalate issues appropriately
- Authorize temporary PharmaCare coverage, benefits and restrictions, after hours
- Control calls
- Resolve transfers from other departments
- Track completed calls in CCA/ITG
- Perform repetitive tasks and answer repetitive questions
- Use a computer for long periods of time

Process documents provided by the providers
- Release (or not) personal information to 3rd Party Requesters
- Correspond with providers to explain policy decisions and to seek or provide information

Understand and comply to policies/procedures set by MAXIMUS Canada, legislation and our clients
- Comply to all regulations, policies and procedures, with mínimal interv