Pharmacy Member Services - 260053

Medix™; Fresno (CA); On-site; USD 29,000 - 32,000; Full time

Job summary

Medix is seeking a Patient Services Representative in Fresno, CA to be the primary contact for patients, pharmacies, and clients across phone, email, and chat. You will assist with benefit questions, claims navigation, and prior authorizations, with a focus on first-call resolution.

You will handle omnichannel inquiries, document interactions with HIPAA-compliant records, and support queue management while delivering compassionate, patient-first care.

Qualifications

• High school diploma or GED
• Customer service experience in a call center, pharmacy, or healthcare setting
• Proficiency with Microsoft Office Suite and ticketing systems
• Strong verbal and written communication with active listening
• Ability to multitask with high accuracy in a fast-paced environment
• Flexibility to work assigned shifts within operating hours

Responsibilities

• Omnichannel support across phone, chat, email with professionalism and empathy
• Benefits & claims navigation and clear communication of coverage
• Prior authorization support and accurate case logging in ticketing system
• Own inquiries from start to finish, escalate complex cases as needed
• Maintain HIPAA-compliant records and assist queue management

Skills

Customer service

Communication skills

Multitasking

Active listening

Attention to detail

Education

High school diploma or GED

Tools

Microsoft Office Suite

Ticketing systems

Job description

Compensation: $21.00 – $23.00/hour (based on pharmacy technician certification/licensure)

Position Overview

As a Patient Services Representative, you will serve as the primary point of contact for patients, retail pharmacies, and clients. You will provide clear, compassionate, and accurate support across phone, email, and chat—answering benefit questions, navigating claims, and assisting with prior authorizations. With dedicated onboarding and a commitment to first-call resolution, you will help simplify complex healthcare processes for callers every day.

What You'll Do

• Omnichannel Support: Handle inbound inquiries from patients, pharmacies, and plan sponsors across multiple channels (phone, chat, email) with professionalism and empathy.
• Benefits & Claims Navigation: Review pharmacy benefit details, troubleshoot claim submissions, and communicate coverage clearly to members.
• Prior Authorization Support: Provide call support for prior authorization requests and log cases accurately in the ticketing system.
• Issue Resolution: Take ownership of inquiries from start to finish, escalating complex clinical or administrative cases when necessary.
• Documentation & Queue Management: Maintain thorough, HIPAA-compliant records of every interaction and assist in keeping pharmacy outreach queues current.

Schedule & Training

• Weekend Rotation: Approximately one weekend shift (Saturday or Sunday) every 6 weeks, paired with an alternate weekday off.

Required Qualifications

• High school diploma or GED equivalent.
• Customer service experience, preferably in a call center, pharmacy, or healthcare setting.
• Proficiency with Microsoft Office Suite (Word, Excel, Outlook, Teams) and ticketing systems.
• Strong verbal and written communication skills with active listening ability.
• Ability to multitask in a fast-paced environment while maintaining high accuracy and patient-first care.
• Flexibility to work assigned shifts within operating hours.

Preferred Qualifications

• Current National Pharmacy Technician Certification (PTCB or ExCPT) and/or state Pharmacy Technician License in good standing.
• Prior experience in Pharmacy Benefit Management (PBM), retail pharmacy, or specialty pharmacy operations.
• Experience handling healthcare or prior authorization calls.
• Associate or Bachelor's degree in a related field.