Support patients, providers, and payers by coordinating reimbursement processes.
About CareMetx
At CareMetx, we are committed to supporting the patient journey from intake to outcomes. We partner with pharmaceutical, biotechnology, and medical device innovators by providing hub services, advanced technology, and decision-making data. Our work ensures that patients get access to specialty products and devices, even when insurers do not cover costs, by managing reimbursements, identifying funding alternatives, and delivering clinical support.
Schedule
- Full-time, remote role
- Must be flexible with hours
- Overtime and occasional weekends may be required
Responsibilities
- Collect and review patient insurance benefit information within program SOP guidelines
- Assist physician offices and patients with completing insurance forms and program applications
- Submit prior authorizations to third-party payers and track follow-up requests
- Maintain frequent communication with providers, payers, and pharmacies
- Document provider, payer, and client interactions in CareMetx Connect
- Provide clear, timely customer service and escalate complaints when necessary
- Monitor reimbursement delays or trends and report to leadership
- Support interdepartmental coordination to resolve issues and improve processes
- Ensure timely processing of correspondence and documentation needed for authorizations
- Report all Adverse Events (AE) per SOP guidelines
Requirements
- High school diploma or GED required
- 1+ years of experience in a specialty pharmacy, medical insurance, physician’s office, healthcare, or related field
- Strong communication skills (oral and written)
- Ability to build productive internal and external relationships
- Strong organizational skills with attention to detail
- Knowledge of pharmacy and medical benefits; understanding of commercial and government payers preferred
- Proficiency in Microsoft Excel, Outlook, and Word
- Ability to problem-solve, manage time effectively, and work independently or in a team environment
Physical & Work Environment
- Primarily desk-based role requiring prolonged sitting
- May occasionally lift up to 10 pounds
- Work environment is typically quiet to moderate
Compensation
- Salary range: $30,490.45 – $38,960.02 annually (commensurate with experience and skills)
Why Join Us
At CareMetx, we work hard and believe deeply in our mission. We provide a supportive, patient-first environment where your work directly improves lives by ensuring access to specialty treatments.
Equal Opportunity Employer
CareMetx is committed to equal employment opportunity. All qualified applicants will receive consideration without regard to race, color, sex, gender identity, religion, age, disability, veteran status, or national origin.
Happy Hunting,
~Two Chicks…