Full-Time
About CareMetx
From intake to outcomes, CareMetx delivers innovative patient access solutions that support the full treatment journey. We partner with pharmaceutical, biotechnology, and medical device innovators to provide hub services, technology, and data insights that help patients access specialty therapies faster and stay on treatment longer. Our team is dedicated to improving patient outcomes, supporting providers, and ensuring seamless reimbursement processes.
Schedule
- Full-time, remote role
- Must be flexible with schedule and hours
- Overtime may be required occasionally
- Weekend availability may be needed based on program demand
Responsibilities
- Conduct benefit investigations and review patient insurance coverage details
- Assist providers and patients with completing and submitting insurance forms and program applications
- Submit prior authorizations, track status, and follow up as needed
- Deliver exceptional customer service, resolving inquiries promptly and escalating issues when appropriate
- Maintain frequent communication with provider offices, payers, and pharmacy staff
- Monitor reimbursement trends or delays and report to leadership
- Process necessary insurance and patient correspondence
- Provide all required documentation for prior authorization, including demographic and clinical details
- Collaborate with internal departments to resolve issues and improve workflows
- Document all interactions in CareMetx Connect system
- Identify and report any adverse events in compliance with SOP and training
Requirements
- High school diploma or GED required
- 1+ year of experience in a specialty pharmacy, medical insurance, physician’s office, or related healthcare setting
- Strong knowledge of pharmacy and medical benefits; familiarity with commercial and government payers preferred
- Strong communication and interpersonal skills (oral and written)
- Negotiation and problem-solving skills with a customer-first mindset
- Proficiency with Microsoft Excel, Outlook, and Word
- Excellent time management, organizational skills, and attention to detail
- Ability to work independently or collaboratively in a fast-paced environment
Salary
$30,490.45 – $38,960.02 annually
Benefits
- Comprehensive medical, dental, and vision coverage
- Paid time off and holidays
- 401(k) retirement savings plan
- Additional perks including life insurance, disability coverage, and employee assistance program (EAP)
- Supportive, mission-driven culture with opportunities for growth
Happy Hunting,
~Two Chicks…