Call Center Representative

Amerit Consulting; California; Remote; USD 25,000 - 29,000; Full time

Job summary

Amerit Consulting is seeking a Call Center Representative for a major PBM client. The role is remote with California residency required, on a 9-month contract with potential for extension and possible full-time conversion.

You will assist members, answer questions about pharmacy benefits and billing, document interactions, and escalate issues as needed in a high-volume environment. Training lasts six weeks (8 AM–5 PM PT) with paid attendance, and weekend shifts are required.

Qualifications

• High school diploma or GED required.
• 0–2 years of customer service experience.
• High-volume call center/customer service experience required.
• Healthcare or pharmacy call center experience preferred.
• Proficient with MS Outlook and data entry applications.

Responsibilities

• Interact with customers to provide information and resolve inquiries.
• Resolve billing complaints by processing adjustments or refunds.
• Respond to inquiries regarding pharmacy benefits, claims, eligibility, and billing.
• Contact customers regarding claim investigation results and planned adjustments.
• Escalate unresolved concerns to appropriate departments.
• Accurately document customer interactions and resolutions.
• Navigate multiple computer systems while maintaining productivity and accuracy.
• Meet quality, productivity, and customer satisfaction targets in a high‑volume call center environment.

Skills

Verbal communication

Written communication

Critical thinking

Problem solving

Conflict resolution

Remote work

PHI confidentiality

Independent work

Education

High school diploma or GED

Tools

MS Outlook

Data entry apps

Multiple systems

Job description

Our client, a major PBM (Pharmacy Benefit Services) entity owned by 20 non-profit health plans serving >33 million members and benefits managers of government programs including Medicare and Medicaid, seeks an accomplished Call Center Representative.

JOB OVERVIEW:

TITLE: Call Center Representative

LOCATION: REMOTE || Must reside in California

DURATION: 9-month contract with high potential for extension and possible full-time conversion

PAY RATE: $18.83/hr. on W2 contract.

IMPORTANT NOTES:

Work Schedule:

• Candidate must be open to work on weekends.
• Shifts are 8 hours between 6:00 AM – 10:00 PM Pacific Time (no graveyard/overnight shifts). Schedules may include any 5 days of the week. Shift time will be confirmed upon job offer as we are hiring over 40 candidates (Candidate should be open to start anytime between 6AM to 1:30PM, shift will be assigned after the training.)
• Candidates must be available to work either one or both weekend days as assigned. Overtime is not regularly expected but may be available on a voluntary basis.

Training Requirements:

• 6 weeks of paid training. 8:00 AM – 5:00 PM PT
• No time off permitted during training.
• Excellent attendance is expected during the first 90 days of employment.

Work-From-Home Related:

• Must reside within the state of California.
• Equipment provided. Must have a hard-wired internet connection (Wi‑Fi is not permitted due to PHI/security requirements). Client provides a 2‑meter Ethernet cable; candidates may need to purchase a longer cable if necessary.
• Quiet, distraction‑free workspace required. Must have a desk/table and office chair. Must be comfortable using a webcam during training, meetings, and as requested by management.

JOB RESPONSIBILITIES:

• The main function of a Member Service Representative is to interact with customers to provide information in response to inquiries about products and services and to handle and resolve complaints. A typical Representative is responsible for determining the client's issue, offering possible solutions, or providing follow‑up as needed. Customer service representatives may handle inbound, outbound, or blended calls.
• Resolve customer service or billing complaints by processing account adjustments, refunds, or other appropriate resolutions.
• Respond to customer inquiries regarding pharmacy benefits, claims, eligibility, billing, and related services.
• Contact customers regarding claim investigation results and planned adjustments.
• Escalate unresolved customer concerns to the appropriate departments.
• Accurately document customer interactions, inquiries, complaints, and resolutions.
• Navigate multiple computer systems while maintaining productivity and accuracy.
• Meet quality, productivity, and customer satisfaction expectations in a high‑volume call center environment.

JOB REQUIREMENTS:

• High school diploma or GED required.
• 0–2 years of customer service experience required.
• High-volume call center/customer service experience required.
• Healthcare or pharmacy call center experience is strongly preferred.
• Previous experience using MS Outlook, data entry applications, and multiple computer systems.
• Proficiency navigating dual monitors and multiple software applications simultaneously.
• Ability to accurately document customer information.
• Strong critical thinking, problem‑solving, and conflict resolution skills.
• Excellent verbal and written communication skills.
• Ability to work independently in a remote environment.
• Ability to maintain confidentiality while handling protected health information (PHI).

PREFERRED QUALIFICATIONS:

• Pharmacy or healthcare customer service experience.
• Experience supporting Medicare, Medicaid, or health insurance members.

Amerit Consulting provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Applicants, with criminal histories, are considered in a manner that is consistent with local, state and federal laws.