Help patients get access to the therapies and devices they need by handling benefits investigations, prior auth support, and payer follow-up with precision. If you’re detail-obsessed, calm on the phones, and know your way around insurance forms and healthcare workflows, this is a clean remote lane.
About CareMetx
CareMetx provides hub services, technology, and data to support the patient journey for pharmaceutical, biotech, and medical device innovators. They specialize in navigating reimbursement and access so patients can receive specialty products without unnecessary delays. This role supports reimbursement operations from intake through prior authorization.
Schedule
- Remote
- Must be flexible on schedule and hours
- Overtime may be required at times
- Weekend work may be required to meet business demands
What You’ll Do
⦁ Collect and review patient insurance benefit information (within program SOP authorization)
⦁ Support benefit investigations, prior authorization intake, and call triage for provider accounts
⦁ Help physician offices and patients complete and submit insurance forms and program applications
⦁ Submit prior authorization forms to third-party payers, track requests, and follow up to push decisions forward
⦁ Document provider, payer, and client interactions accurately in the CareMetx Connect system
⦁ Maintain frequent phone contact with provider reps, payer customer service, and pharmacy staff
⦁ Escalate complaints appropriately and report reimbursement trends or delays to your supervisor
⦁ Ensure required documentation is gathered to expedite authorizations (demographics, referrals, NPI, referring physician info, etc.)
⦁ Coordinate with internal teams as needed and report Adverse Events (AE) per training and SOP
What You Need
⦁ High School Diploma or GED
⦁ 1+ year experience in specialty pharmacy, medical insurance, physician office, healthcare setting, or related environment
⦁ Strong written and verbal communication with customer-service discipline
⦁ Detail-driven organization, time management, and follow-through
⦁ Working knowledge of pharmacy and medical benefits (global understanding of commercial and government payers is a plus)
⦁ Proficiency with Microsoft Excel, Outlook, and Word
⦁ Ability to work independently, problem-solve, and handle moderate-scope issues within SOPs
Benefits
⦁ Salary range: $30,490.45 – $38,960.02
⦁ Mission-driven work supporting patient access to specialty products and devices
⦁ Remote work environment with collaborative cross-functional coordination
If your strength is keeping prior auths from dying in limbo, apply now. These roles move faster when teams are trying to reduce delays and backlogs.
Get the paperwork right, keep the calls tight, and help patients get to “approved.”
Happy Hunting,
~Two Chicks…