Pharmacy Technician Certified Representative

Job Summary

Supporting Medicare members and providers, the full-time Remote Medicare Customer Service Representative will process coverage-related requests, conduct outreach, and ensure compliance with Medicare guidelines while working remotely.

Key responsibilities

• Process coverage-related requests including prior authorizations and appeals while maintaining compliance with CMS standards
• Conduct outbound calls to gather necessary information from members and providers, documenting case activity accurately across multiple systems
• Participate in ongoing training and professional development to enhance operational excellence and support continuous improvement

Required qualifications

• High School Diploma or equivalent
• Minimum of 6 months of experience in customer service, healthcare, pharmacy, or call center environments
• Proficiency in navigating multiple computer systems in a Windows-based environment
• Ability to interpret Medicare regulations and business correspondence
• Typing speed of 30 WPM or greater