Help patients access the treatments they need by untangling the insurance and reimbursement side of their care. This fully remote role is perfect if you’re detail-driven, love problem solving, and want steady work in the specialty pharmacy / healthcare space.
About CareMetx
CareMetx supports the full patient journey “from intake to outcomes” by providing hub services, innovative technology, and data-driven solutions to pharma, biotech, and medical device companies. The team focuses on removing reimbursement barriers so patients can start and stay on therapy. You’ll join a mission-focused organization that blends service, tech, and healthcare expertise.
Schedule
- Remote role with a standard full-time schedule
- Must be flexible with hours based on program and business needs
- Overtime may be required at times
- Must be willing to work some weekends if needed to meet demand
What You’ll Do
- Collect and review patient insurance benefit information in line with program SOPs
- Assist physician office staff and patients in completing and submitting insurance forms and program applications
- Complete and submit prior authorization forms to third-party payers and track/follow up on requests
- Respond to provider account inquiries and deliver high-quality customer service to internal and external stakeholders
- Maintain frequent phone contact with provider reps, payer reps, and pharmacy staff
- Document all provider, payer, and client interactions in the CareMetx Connect system
- Report reimbursement trends, delays, or issues to your supervisor
- Process insurance and patient correspondence related to reimbursement
- Provide all necessary documentation (demographics, authorizations, NPI, referring provider info) to support prior authorization requests
- Coordinate with interdepartmental associates to resolve issues and keep cases moving
- Communicate effectively with payers to ensure accurate and timely benefit investigations
- Report all Adverse Events in line with training and SOPs
- Work within defined SOPs, using judgment to resolve problems of moderate scope
- Handle other duties as assigned as programs and needs evolve
What You Need
- High school diploma or GED
- At least 1 year of experience in a specialty pharmacy, medical insurance, physician’s office, healthcare setting, or related environment
- Strong verbal and written communication skills
- Ability to build productive working relationships with internal teams and external partners
- General knowledge of pharmacy and medical benefits; familiarity with commercial and government payers preferred
- Proficiency with Microsoft Excel, Outlook, and Word
- Strong interpersonal, negotiation, organizational, and time management skills
- Solid problem-solving ability and comfort working within SOPs
- Customer-satisfaction mindset and ability to work independently or as part of a team
Benefits
- Estimated salary range of $30,490.45–$38,960.02 per year, depending on experience
- Fully remote work environment
- Opportunity for overtime when business needs increase
- Chance to grow in a niche, mission-driven space supporting patient access to specialty therapies
- Inclusive, equal-opportunity culture that values diversity and merit-based advancement
If you’re ready to use your reimbursement know-how to make real impact in patients’ access to care, this is your lane.
Don’t overthink it—strong candidates move quickly on roles like this.
Happy Hunting,
~Two Chicks…