Healthcare Customer Service Representative

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Act as the main contact for patients, healthcare providers, and specialty pharmacies for program support and therapy access.

• Provide assistance with benefit verification, eligibility assessment, program enrollment, affordability support, and reimbursement guidance.

• Tackle payer-related challenges by investigating coverage requirements and proposing suitable solutions.

• Build and sustain relationships with healthcare providers and patients through continuous communication and support.

• Inform stakeholders about commercial and government insurance benefits, including Medicare, Medicaid, Veterans Affairs (VA), and Department of Defense (DOD) plans.

• Accurately document and maintain case records in compliance with program guidelines, company policies, and regulatory standards.

• Work in conjunction with Program Management and internal teams to meet patient needs, resolve issues, and enhance program efficiency.

• Refer complex cases as per standard operating procedures (SOPs) and program guidelines.

• Facilitate inbound and outbound communications via phone and email.

• Track patient cases to ensure prompt follow-up and favorable outcomes.

• Manage sensitive information with utmost confidentiality and professionalism.

⛳️ Requirements

• Prior experience in a HUB, Patient Services, Case Management, or a similar healthcare support role.

• Required experience in a contact center or customer service setting.

• Familiarity with pharmaceutical benefit processes and patient access programs is essential.

• Knowledge of commercial and government payers, including Medicare Part B.

• Experience in communicating with patients, physician offices, and specialty pharmacies.

• Strong abilities in problem-solving, organization, and relationship development.

• Excellent verbal and written communication skills.

• Capability to work independently in a remote setting while juggling multiple priorities.

• 1-2 years of experience in pharmaceutical benefits, reimbursement support, patient services, or healthcare case management.

• Understanding of benefit verification, prior authorization processes, and insurance coverage navigation.

🏝️ Benefits

• Fully remote work environment.

• Competitive pay rate.

• Opportunity to significantly impact patient access to care.

• Collaborative and supportive team culture.

• Opportunities for growth within the healthcare and patient services field.

• Medical, dental, and vision coverage.

• Critical Illness, Accident, and Hospital insurance.

• 401(k) Retirement Plan with pre-tax and Roth post-tax contributions available.

• Life Insurance (Voluntary Life & AD&D for the employee and dependents).

• Short and long-term disability insurance.

• Health Spending Account (HSA).

• Transportation benefits.

• Employee Assistance Program.

• Time Off/Leave (PTO, Vacation, or Sick Leave).