Remote Pharmacy Benefit Support Specialist

TEKsystems; United States; Remote; USD 26,000 - 28,000; Full time

Benefits offered by this job

Medical, dental & vision benefits

401(k) Retirement Plan

Life Insurance

Disability insurance (short & long)

Health Spending Account (HSA)

Transportation benefits

Employee Assistance Program

Paid Time Off

Job summary

TEKsystems is hiring for a fully remote Healthcare/Pharmacy Customer Service Representative, operating in the EST time zone with approved states across FL, GA, MD, NJ, NC, PA, SC, and TX. The role supports members, providers, pharmacies, brokers, and internal teams with pharmacy benefit questions and claim resolutions.

Requirements include 2-3 years in healthcare call center or medical scheduling, with insurance verification or authorizations experience as a plus.

Qualifications

• 2-3 years of healthcare call center or medical scheduling experience required.
• Experience with insurance verification or authorizations is a huge plus.
• Experience with healthcare insurance is also a plus.

Responsibilities

• Respond to inbound calls and inquiries related to commercial pharmacy benefits, prescription coverage, pharmacy claims, and plan information.
• Assist members, providers, brokers, internal teams, and other stakeholders with pharmacy-related questions and issue resolution.
• Research and resolve inquiries using internal systems, routing queues, vendor applications, plan documents, and knowledge resources.
• Review and interpret pharmacy benefit information, policies, procedures, and plan requirements to provide accurate guidance.
• Document all interactions thoroughly and accurately in accordance with compliance and procedural standards.
• Escalate complex issues when needed and coordinate with internal teams or vendor contacts to support resolution.
• Maintain compliance with HIPAA, organizational, plan, and regulatory requirements.
• Meet quality, productivity, and customer experience expectations in a structured, monitored environment.
• Participate in training and coaching to maintain current knowledge of commercial pharmacy benefits, plan requirements, and internal processes.

Skills

Healthcare call center

Healthcare scheduling

Insurance verification

Authorizations

Customer service

Education

High School Diploma or GED

Tools

Internal systems

Vendor applications

Job description

TEKsystems is hiring for a fully remote Healthcare/Pharmacy Customer Service Representative, operating in the EST time zone with approved states across FL, GA, MD, NJ, NC, PA, SC, and TX. The role supports members, providers, pharmacies, brokers, and internal teams with pharmacy benefit questions and claim resolutions.

Requirements include 2-3 years in healthcare call center or medical scheduling, with insurance verification or authorizations experience as a plus.