Help patients access life-changing medications from the comfort of your home. As a Reimbursement Specialist, you’ll handle benefits investigations, prior authorizations, and payer follow-up so patients and providers can move faster from prescription to treatment.
About CareMetx
CareMetx partners with pharmaceutical, biotechnology, and medical device companies to support the full patient journey. They provide hub services, technology, and data that remove barriers to access so patients can start and stay on specialty therapies. Their work sits at the intersection of healthcare, insurance, and patient advocacy.
Schedule
- Full-time, remote role (home-based within the United States)
- Must be flexible with schedule and hours
- Overtime may be required at times to meet program demand
- Weekend work may be required based on client or workload needs
What You’ll Do
- Gather, review, and verify patient insurance benefits according to program SOPs
- Complete and submit prior authorization forms and other payer-required documentation in a timely manner
- Track and follow up on prior authorizations to help avoid delays in therapy
- Assist physician office staff and patients in completing necessary insurance and program applications
- Maintain frequent phone and email contact with provider offices, payers, and pharmacies
- Respond to provider account inquiries and document all interactions in internal systems (CareMetx Connect)
- Communicate effectively with payers to ensure accurate and timely benefit investigations
- Identify and report reimbursement trends, delays, or recurring issues to leadership
- Process insurance and patient correspondence related to reimbursement or access
- Collaborate with internal teams as needed to resolve issues and support the patient journey
- Report any Adverse Events in line with training and standard operating procedures
What You Need
- High school diploma or GED required
- At least 1 year of experience in one or more of the following: specialty pharmacy, medical insurance, physician office, or healthcare/reimbursement support
- General knowledge of pharmacy and medical benefits; familiarity with commercial and government payers is a plus
- Strong verbal and written communication skills with a customer-focused mindset
- Ability to build productive relationships with providers, payers, and internal teams
- Strong organizational skills, accuracy, and attention to detail
- Ability to work with moderate complexity issues and exercise judgment within defined SOPs
- Proficiency with Microsoft Excel, Outlook, and Word
- Ability to work independently and as part of a team, manage time well, and meet deadlines
- Problem-solving mindset and comfort working in a fast-paced, metrics-driven environment
Benefits
- Estimated salary range: 30,490.45 to 38,960.02 dollars per year
- Remote work with the ability to support patients across the U.S.
- Opportunity to grow skills in reimbursement, payer navigation, and patient access
- Work supporting specialty medications, devices, and therapies that make a direct impact
- Inclusive, equal-opportunity employer committed to fair hiring practices
Roles like this are ideal if you’ve touched prior auths, benefits verification, or pharmacy/medical billing and want a fully remote, healthcare-adjacent role with clear impact.
If this fits your background and you’re ready to help patients move from prescription to outcomes, don’t sit on it.
Happy Hunting,
~Two Chicks…