Be the steady guide who helps patients and providers get specialty therapies approved, funded, and moving, without the runaround. If you’ve lived in benefits investigations, prior auth, and payer problem-solving, this role puts your follow-through to work in a big way.
About CareMetx
CareMetx supports the patient journey with hub services, technology, and data that help pharmaceutical, biotech, and medical device innovators get therapies to the people who need them. They manage reimbursements, uncover alternative funding when coverage fails, and provide patient support services that improve access and outcomes.
Schedule
- Remote role
- Must be flexible on schedule and hours
- Overtime may be required at times
- Weekend work may be required to meet company demands
What You’ll Do
⦁ Serve as a single point of contact for patients and providers, acting as an advocate with compassion
⦁ Coordinate access to therapies, complete follow-ups, and connect patients to appropriate support services
⦁ Manage an assigned caseload based on program parameters
⦁ Collect, review, and validate patient information per program SOP
⦁ Guide patients and physician offices through completing and submitting program applications on time
⦁ Determine eligibility and support enrollment for programs like patient assistance and copay assistance
⦁ Handle reimbursement activities including benefits investigations, prior authorizations, and appeals
⦁ Deliver excellent customer service, resolve issues accurately, and escalate complaints when needed
⦁ Maintain frequent phone contact with patients, providers, payer reps, and pharmacy staff
⦁ Document all interactions in CareMetx Connect in compliance with HIPAA regulations
⦁ Report Adverse Events (AE) according to training and SOP
⦁ Coordinate with internal teams and exercise judgment within defined procedures
⦁ Support additional duties as assigned as programs evolve
What You Need
⦁ Preferred: 3+ years of experience in specialty pharmacy, medical insurance, reimbursement hub work, physician office, healthcare, or insurance background
⦁ Bachelor’s Degree preferred
⦁ Strong verbal and written communication skills
⦁ Ability to multitask and adapt quickly as priorities shift
⦁ Proficient keyboard skills and comfort with Microsoft Word and Excel
⦁ Knowledge of HIPAA regulations and strong documentation habits
⦁ Detail-oriented, highly organized, and customer-focused
⦁ Knowledge of pharmacy and medical benefits (commercial and government payer familiarity preferred)
⦁ Ability to work independently and collaboratively, with solid problem-solving skills
Benefits
⦁ Compensation range: $38,418.30 – $51,224.15
⦁ Remote work opportunity
⦁ Impact-driven work helping patients access specialty therapies and support services
⦁ Equal opportunity employer
These cases don’t manage themselves. If you’re the type who closes loops, protects patient experience, and knows how to speak “payer,” this one’s calling you.
Happy Hunting,
~Two Chicks…