Pharmacy Benefits Advocate — Remote/Hybrid

The OccuNet Company; Amarillo (TX); Hybrid; USD 38,000 - 45,000; Full time

Benefits offered by this job

401(k) with matching

Health insurance

Dental insurance

Vision insurance

Health savings account

Job summary

The OccuNet Company in Amarillo, TX is seeking a FairosRx Member Advocate to support members, pharmacies, and physicians with information on pharmacy benefits, claims, and access programs. You will handle inquiries via phone, chat, and email with clarity and compassion.

The role emphasizes teamwork in a fast-paced setting, adherence to HIPAA, and collaboration with Clinical, Account Management, and Operations teams to resolve complex cases and improve the member experience.

Qualifications

• High school diploma or equivalent required.
• PBM experience strongly preferred; healthcare or call center experience valued.
• Strong verbal and written communication; patient-focused mindset.

Responsibilities

• Provide clear, empathetic assistance to members regarding pharmacy benefits and copays.
• Resolve claim questions and issues for pharmacies.
• Assist providers with prior authorizations and drug coverage.
• Identify claims needing action and initiate outreach.
• Document interactions in the ticketing system per procedures.
• Adhere to HIPAA and privacy policies.
• Participate in call quality reviews and continuous improvement.

Skills

PBM experience

Customer service

Verbal communication

Written communication

Teamwork

MS Office

Multitasking

Active listening

Problem solving

Education

High school diploma or equivalent

Pharmacy technician background

Healthcare/call center experience

Tools

PBM software

Ticketing system

CRM software

Job description

The OccuNet Company in Amarillo, TX is seeking a FairosRx Member Advocate to support members, pharmacies, and physicians with information on pharmacy benefits, claims, and access programs. You will handle inquiries via phone, chat, and email with clarity and compassion.

The role emphasizes teamwork in a fast-paced setting, adherence to HIPAA, and collaboration with Clinical, Account Management, and Operations teams to resolve complex cases and improve the member experience.