Remote Health Support Specialist

Capital Rx Inc.; New York (NY); Remote; USD 30,000 - 41,000; Full time

Job summary

Judi Health is seeking a customer service-focused specialist to triage and resolve member and pharmacy inquiries from a remote setting in the United States. You will support call center staff, escalate issues to internal teams, and ensure compliance with HIPAA and company policies.

You should have 2+ years in customer service or healthcare, with Medicare experience preferred and Spanish language skills highly valued for effective communication with diverse clients.

Qualifications

• 2+ years of customer service, call center, and/or health care experience.
• 2+ years of PBM or related Health Care experience required.
• Bilingual Spanish highly preferred.
• Medicare experience preferred.
• Ability to work independently with minimal supervision in a remote, high-volume environment.

Responsibilities

• Triage incoming calls from members and pharmacies with professional etiquette and identify issues.
• Provide support for call center staff and other technicians.
• Escalate member and pharmacy concerns to the appropriate internal teams.
• Communicate issues and solutions to members, pharmacies, and internal stakeholders to ensure quality care.
• Aim for first-call resolution and de-escalate customer concerns.
• Ensure adherence to HIPAA and company policies in all interactions.
• Support the Fraud, Waste, and Abuse program by reviewing pharmacy claims information.
• Multitask across multiple systems in a fast-paced environment.

Skills

Customer service

Call center

Healthcare experience

Education

High school diploma

Associates degree preferred

Bachelor’s degree preferred

Job description

Judi Health is seeking a customer service-focused specialist to triage and resolve member and pharmacy inquiries from a remote setting in the United States. You will support call center staff, escalate issues to internal teams, and ensure compliance with HIPAA and company policies.

You should have 2+ years in customer service or healthcare, with Medicare experience preferred and Spanish language skills highly valued for effective communication with diverse clients.