Support patient access by navigating insurance, benefits, and prior authorizations in a fast-paced healthcare services environment.
About CareMetx
CareMetx partners with pharmaceutical, biotechnology, and medical device innovators to support the patient journey. From hub services to innovative technology and data solutions, CareMetx ensures patients receive the treatments they need by managing reimbursements, navigating prior authorizations, and identifying funding alternatives.
Schedule
- Full-time, remote role
- Must be flexible with schedule, including potential overtime and occasional weekends based on company needs
Responsibilities
- Conduct benefit investigations and prior authorization support for patients
- Collect, review, and submit all necessary insurance forms in compliance with payer requirements
- Provide exceptional customer service to providers, payers, and clients, resolving inquiries quickly and accurately
- Maintain frequent communication with provider representatives, payers, and pharmacies
- Track and follow up on prior authorization requests
- Document all interactions accurately in the CareMetx Connect system
- Report reimbursement delays or trends to leadership
- Collaborate across departments to support smooth workflows
- Ensure HIPAA compliance and report adverse events per SOPs
Requirements
- High School Diploma or GED required
- 1+ years of experience in specialty pharmacy, medical insurance, physician’s office, or healthcare setting
- Strong communication skills (oral and written) with ability to explain complex information
- Knowledge of medical and pharmacy benefits; familiarity with commercial and government payers preferred
- Proficiency in Microsoft Excel, Outlook, and Word
- Strong organizational skills, attention to detail, and ability to manage time effectively
- Customer-focused with strong problem-solving abilities
- Ability to work independently or as part of a team
Compensation
- Salary Range: $30,490.45 – $38,960.02 annually
Benefits
- Comprehensive medical, dental, and vision coverage
- Paid Time Off and company holidays
- 401(k) with employer match
- Additional region-specific benefits available
Why Work Here
CareMetx is committed to doing right by employees and patients alike. You’ll join a mission-driven team that helps patients access life-saving therapies, while building a career in a growing niche industry.
Happy Hunting,
~Two Chicks…