Recommended Minimum Skills Requirements (MSRs):

1. Technical Skills:
   • Proficiency in Microsoft Office Suite (Word, Excel, Outlook)

1. Soft Skills:
   • Strong problem-solving and decision-making abilities
   • Excellent verbal and written communication skills in English
   • High level of empathy, patience, and active listening
2. Operational and Communication Skills:
   • Ability to prioritize tasks and meet deadlines in a fast-paced environment
   • Strong organizational and documentation skills
   • Accuracy and attention to detail
   • Ability to communicate effectively and convey complex information

KEY RESPONSIBILITIES:

1. Grievance Handling:
   o Investigate and resolve member grievances related to Medicare Part D drug
   coverage, claims, and pharmacy issues
   o Ensure all grievances are resolved within required CMS timelines and documented
   appropriately
2. Communication:
   o Act as a liaison between members, providers, and pharmacies for Medicare
   grievance resolution
   o Provide clear and empathetic communication throughout the grievance process
3. Compliance:
   o Adhere to all CMS (Centers for Medicare & Medicaid Services) guidelines and
   company policies
   o Maintain confidentiality of sensitive member information
4. Documentation:
   o Accurately document all interactions and resolutions in the client system
   o Prepare reports as required for compliance and auditing purposes
5. Collaboration:
   o Work closely with other departments to investigate and resolve grievances
   o Provide insights and feedback on recurring issues to improve processes
   Recommended Minimum Skills Requirements (MSRs)