Hybrid Healthcare Support Specialist

Prime Therapeutics; Helena (MT); Hybrid; USD 25,000 - 35,000; Full time

Job summary

Prime Therapeutics is seeking a Customer Care Specialist who will provide frontline support to members and providers. The hybrid role requires resolving inquiries on eligibility, benefits, claims, and authorizations with a focus on first-call resolution.

The ideal candidate demonstrates strong communication, typing speed, and multitasking abilities, with familiarity in healthcare terminology and HIPAA regulations.

Qualifications

• High school diploma or GED required.
• Healthcare/call center experience preferred.
• Knowledge of HIPAA and healthcare terminology helpful.

Responsibilities

• Engage inbound callers and resolve administrative concerns related to claims and eligibility.
• Make outbound calls to resolve member issues or obtain information for prior authorizations.
• Research member information across systems while maintaining confidentiality.
• Educate providers and members on claims submission, treatment plans, and reimbursement processes.
• Document interactions and forward inquiries to appropriate staff or teams.
• Identify and respond to routine issues; triage when clinical judgment is not required.
• Support process improvements and handle high-volume calls.

Skills

Communication

Multitasking

Typing 35+ WPM

Healthcare terminology

HIPAA knowledge

Scheduling flexibility

CRM experience

Education

High school diploma or GED

Tools

Genesys

CRM platforms

Job description

Prime Therapeutics is seeking a Customer Care Specialist who will provide frontline support to members and providers. The hybrid role requires resolving inquiries on eligibility, benefits, claims, and authorizations with a focus on first-call resolution.

The ideal candidate demonstrates strong communication, typing speed, and multitasking abilities, with familiarity in healthcare terminology and HIPAA regulations.