If you’ve got healthcare admin experience and you’re good at working insurance like a chess match, this role is a strong fit. You’ll run benefit investigations, support prior authorizations, and be the steady point of contact between providers, payers, and internal teams.
About CareMetx
CareMetx supports the patient journey with hub services, technology, and decision-support data for pharmaceutical, biotech, and medical device companies. Their work helps patients access specialty products by managing reimbursement, navigating payer requirements, and smoothing out the process when things get stuck.
Schedule
• Remote
• Must be flexible on schedule and hours
• Overtime may be required at times
• Weekend work may be required based on business needs
What You’ll Do
⦁ Collect and review patient insurance benefit information according to program SOPs
⦁ Help physician office staff and patients complete and submit insurance forms and program applications
⦁ Submit prior authorization documentation to third-party payers, track requests, and follow up until resolved
⦁ Provide strong customer service, resolve requests accurately, and escalate complaints when needed
⦁ Maintain frequent phone contact with provider reps, payer customer service, and pharmacy staff
⦁ Document provider, payer, and client interactions in the CareMetx Connect system
⦁ Identify and report reimbursement trends or delays to your supervisor
⦁ Process insurance and patient correspondence as required
⦁ Gather and submit required PA documentation (demographics, referrals/authorizations, NPI, referring physician info, etc.)
⦁ Coordinate with internal departments to keep cases moving
⦁ Communicate with payers to ensure accurate and timely benefit investigations
⦁ Report any Adverse Events (AEs) per training and SOP
⦁ Handle moderate-scope problems, using judgment within defined procedures
What You Need
⦁ High school diploma or GED
⦁ 1+ years of experience in a specialty pharmacy, medical insurance, physician office, healthcare setting, or related role
⦁ Strong verbal and written communication skills
⦁ Ability to build productive internal and external relationships
⦁ Strong interpersonal and negotiating skills
⦁ Strong organization, attention to detail, and time management
⦁ General understanding of pharmacy and medical benefits
⦁ Understanding of commercial and government payers (preferred)
⦁ Proficiency with Microsoft Excel, Outlook, and Word
⦁ Ability to work independently and as part of a team
⦁ Problem-solving mindset with a customer-first approach
Benefits
⦁ Not listed in the posting (focus is on role scope, schedule flexibility, and salary range)
⦁ Salary range: $30,490.45 – $38,960.02
One honest note: that salary range is modest for reimbursement work, especially if overtime/weekends pop up. If you apply, go in eyes open and be ready to ask about overtime frequency, shift expectations, and workload volume in the interview.
If you want a remote healthcare role that builds payer/PA chops and you don’t mind phones plus documentation, apply now.
Happy Hunting,
~Two Chicks…