Help patients actually get the meds and treatments their doctors prescribe, without leaving your home office. As a Remote Reimbursement Specialist with CareMetx, you’ll live in the middle of the insurance maze—helping providers and patients navigate benefits, prior authorizations, and coverage so care doesn’t stall out.
About CareMetx
CareMetx supports the full patient journey for pharmaceutical, biotech, and medical device innovators by combining hub services, technology, and data. From intake to outcomes, they focus on getting specialty therapies to the patients who need them, managing reimbursements, identifying funding when insurance falls short, and providing clinical support. It’s a mission-driven environment where your daily work directly impacts whether patients can start and stay on therapy.
Schedule
- Fully remote position
- Must be flexible on schedule and hours
- Overtime may be required based on business needs
- Willingness to work some weekends if needed to meet program demands
What You’ll Do
⦁ Collect and review patient insurance benefit information according to program SOPs, ensuring accuracy and completeness.
⦁ Assist physician office staff and patients with completing and submitting insurance forms and program applications.
⦁ Complete and submit prior authorization requests to third-party payers, track status, and follow up until resolved.
⦁ Provide exceptional customer service to providers, payers, pharmacies, and internal teams, escalating complaints when appropriate.
⦁ Maintain frequent phone contact with provider reps, payer customer service, and pharmacy staff to keep cases moving forward.
⦁ Prepare and process insurance and patient correspondence related to coverage, benefits, and authorizations.
⦁ Gather and document all information needed to expedite prior authorizations, including demographics, referrals, NPI, and referring physician details.
⦁ Coordinate with internal departments as needed and communicate effectively with payers to ensure timely benefit investigations.
⦁ Monitor reimbursement trends or delays and report them to leadership.
⦁ Work within defined SOPs to analyze information, solve moderate-scope problems, and determine appropriate actions.
⦁ Document all interactions thoroughly in the CareMetx Connect system and report any Adverse Events (AE) per training and SOPs.
What You Need
⦁ High school diploma or GED required.
⦁ At least 1 year of experience in a specialty pharmacy, medical insurance, physician’s office, healthcare setting, or similar environment.
⦁ Strong verbal and written communication skills and the ability to build productive working relationships.
⦁ General knowledge of pharmacy and medical benefits; understanding of commercial and government payers is preferred.
⦁ Solid organizational skills, attention to detail, and strong time management.
⦁ Proficiency with Microsoft Excel, Outlook, and Word.
⦁ Ability to work independently and as part of a team, with solid problem-solving skills and a customer-focused mindset.
Benefits
⦁ Competitive salary range: approximately $30,490–$38,960 per year, depending on experience.
⦁ Fully remote role with the ability to contribute from your home office.
⦁ Opportunity to work in a niche, mission-driven space that directly impacts patient access to specialty therapies.
⦁ Collaborative culture focused on doing right by patients, providers, and employees.
Mission-driven remote reimbursement roles like this get snapped up quickly—especially by people who actually understand what’s at stake for patients.
If you’re ready to put your insurance and reimbursement skills to work helping real patients get real treatments, this could be your next move.
Happy Hunting,
~Two Chicks…