Pharmacy Technician Certified Customer Service Representative

Job Summary

To support a growing healthcare team, the full-time Remote Medicare Customer Service Representative will process coverage-related requests, communicate with members and providers, and maintain accurate documentation while working remotely during scheduled shifts, including rotating weekends.

Key responsibilities

• Process incoming requests for prior authorizations, coverage determinations, and appeals through phone and fax channels
• Communicate professionally with members, providers, and prescribers to gather necessary information and ensure a positive customer experience
• Maintain accurate documentation and meet CMS turnaround requirements while collaborating with pharmacists and leadership to resolve complex issues

Required qualifications

• High School Diploma or equivalent
• Minimum of 1 year of customer service, healthcare, pharmacy, call center, or related experience
• Proficiency navigating multiple Windows-based computer systems
• Typing speed of at least 30 words per minute
• Preferred Pharmacy Technician Certification (CPhT)