Remote Pharmacy Benefits Expert

ExactCare Pharmacy; Cleveland (OH); Remote; USD 42,000 - 60,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

401(k) with company match

Paid time off & holidays

Job summary

AnewHealth is seeking a Customer Support Specialist to answer calls from clients and provide accurate, courteous assistance. You will educate on plan benefits, process prior authorizations, and collaborate on JIRA tickets for billing, prescriptions, and NDC issues.

Remote work with standard EST hours and a focus on HIPAA compliance and excellent client service. Experience in healthcare and Medicare guidelines is preferred, with a commitment to professional communication.

Qualifications

• Associate’s degree or equivalent combination of education or work experience.
• 3+ years of customer service experience in a call center or similar.
• 2+ years in healthcare.
• Knowledge of plan structures and Medicare guidelines.

Responsibilities

• Answer telephone inquiries in a pleasant, professional, and efficient manner.
• Document all calls and dialogue in the claims adjudication software.
• Educate clients on plan policies, benefits, and procedures.
• Initiate and facilitate prior authorization requests.
• Submit JIRA tickets for claims, prescriptions, pricing, and NDC issues.
• Ensure HIPAA compliance in all communications.

Skills

Customer service

Communication skills

Problem solving

Detail oriented

Education

Associate's degree or equivalent

CPhT Certification

Tools

JIRA

Microsoft Office

Job description

AnewHealth is seeking a Customer Support Specialist to answer calls from clients and provide accurate, courteous assistance. You will educate on plan benefits, process prior authorizations, and collaborate on JIRA tickets for billing, prescriptions, and NDC issues.

Remote work with standard EST hours and a focus on HIPAA compliance and excellent client service. Experience in healthcare and Medicare guidelines is preferred, with a commitment to professional communication.