Help patients move from “stuck in the paperwork” to “care can actually happen.” If you’ve handled benefits, prior auth, and payer calls before, this is a remote role where your follow-through matters every day.
About CareMetx
CareMetx supports the patient journey with hub services, technology, and decision-making data for pharmaceutical, biotech, and medical device innovators. They help get specialty products and devices to the patients who need them by managing reimbursements, navigating payer requirements, and identifying alternative funding when coverage falls short.
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
⦁ Collect and review patient insurance benefits information per program SOP
⦁ Support benefit investigations, prior authorization submissions, and call triage
⦁ Assist physician offices and patients with insurance forms and program applications
⦁ Submit prior auth requests, track status, and follow up with payers as needed
⦁ Document provider, payer, and client interactions in the CareMetx Connect system
⦁ Maintain frequent phone contact with providers, payer reps, and pharmacy staff
⦁ Report reimbursement trends and delays to your supervisor
⦁ Process insurance and patient correspondence as needed
⦁ Gather documentation to expedite prior auth, including demographics, authorizations or referrals, NPI, and referring physician details
⦁ Coordinate with internal teams and escalate complaints appropriately
⦁ Report Adverse Events (AE) in alignment with training and SOP
What You Need
⦁ High School Diploma or GED required
⦁ 1+ year of experience in specialty pharmacy, medical insurance, a physician office, healthcare setting, or related experience
⦁ Working knowledge of pharmacy benefits and medical benefits (commercial and government payer familiarity preferred)
⦁ Strong communication skills, attention to detail, organization, and time management
⦁ Confidence handling payer and provider conversations, including negotiation and problem-solving
⦁ Proficiency with Microsoft Excel, Outlook, and Word
⦁ Ability to work independently and as part of a team
Benefits
⦁ Remote work opportunity
⦁ Compensation range: $30,490.45 – $38,960.02
⦁ Work in a niche healthcare space helping patients access specialty products and devices
⦁ Equal opportunity employer
If you’ve got prior auth stamina and you don’t let tasks die in your inbox, jump on this one.
Bring your “I’ll get it done” energy and help move patients from intake to outcomes.
Happy Hunting,
~Two Chicks…