Help patients and provider offices navigate benefits, prior auth, and payer requirements so care doesn’t get stuck in red tape. If you’re organized, calm on the phone, and sharp with details, this is steady, meaningful work.
About CareMetx
CareMetx supports the patient journey with hub services, technology, and data for pharmaceutical, biotech, and medical device innovators. They specialize in helping specialty products and devices reach the patients who need them by managing reimbursement and related support.
Schedule
- Remote
- Must be flexible on schedule and hours
- Overtime may be needed at times
- Weekend work may be required based on company needs
What You’ll Do
- Conduct benefit investigations by collecting and reviewing patient insurance information per program SOPs
- Support prior authorizations by completing, submitting, tracking, and following up on PA requests
- Assist provider offices and patients with insurance forms and program applications
- Triage inbound calls and respond to provider account inquiries
- Document all payer, provider, and client interactions in the CareMetx Connect system
- Maintain frequent phone contact with providers, payers, and pharmacy staff to move cases forward
- Identify and report reimbursement trends or delays to your supervisor
- Gather and submit required documentation for PAs (demographics, referrals/authorizations, NPI, referring physician details, etc.)
- Coordinate with internal teams to resolve issues and keep cases moving
- Report adverse events (AEs) according to training and SOPs
- Handle other duties as assigned as programs evolve
What You Need
- High school diploma or GED (required)
- 1+ year of experience in a specialty pharmacy, medical insurance, physician’s office, healthcare setting, or related environment
- Strong written and verbal communication skills
- Solid relationship-building and customer service mindset
- Strong organization, attention to detail, and time management
- Negotiation skills and the ability to problem-solve with limited daily oversight
- Working knowledge of pharmacy and medical benefits (commercial and government payer familiarity is a plus)
- Proficiency with Microsoft Excel, Outlook, and Word
- Ability to work independently and as part of a team
Benefits
- Not listed in the posting (ask during the recruiter screen)
Compensation
- Salary range: $30,490.45 – $38,960.02
If you’ve done benefits investigations or prior auth work before, this role is a clean match. And if you haven’t, but you’ve lived in insurance phones and paperwork, you can still be dangerous here.
Happy Hunting,
~Two Chicks…