Pharmacy Customer Service Representative

This is a fully remote position, open to applicants in Florida, +6 more states.

📋 Description

• This position provides support to Medicare members, providers, pharmacies, brokers, and internal teams regarding questions about prescription drug coverage and pharmacy benefits.

• Handle incoming calls and inquiries related to Medicare pharmacy benefits, prescription coverage, pharmacy claims, and plan details.

• Assist members, providers, brokers, internal teams, and other stakeholders with pharmacy-related inquiries and problem resolution.

• Investigate and resolve inquiries by utilizing internal systems, routing queues, vendor applications, plan documents, and knowledge resources.

• Analyze and interpret pharmacy benefit information, policies, procedures, and plan requirements to deliver accurate guidance.

• Document all interactions comprehensively and accurately in line with compliance and procedural standards.

• Elevate complex issues as necessary and collaborate with internal teams or vendor contacts to facilitate resolution.

• Adhere to HIPAA, Medicare, organizational, and regulatory compliance requirements.

• Achieve quality, productivity, and customer experience goals in a structured, monitored setting.

• Engage in training and coaching to keep up-to-date with pharmacy benefits, Medicare programs, and internal processes.

⛳️ Requirements

• A High School Diploma or GED is mandatory.

• Previous customer service or call center experience is essential.

• Excellent verbal and written communication abilities.

• Capable of clearly and professionally explaining detailed or complex information.

• Strong focus on detail and accuracy.

• Comfortable using multiple systems while assisting callers.

• Ability to work both independently and collaboratively within a team.

• Dependable attendance and capacity to operate in a structured, performance-oriented environment.

• Experience as a pharmacy technician is highly preferred.

• Familiarity with Medicare, Medicare Part D, pharmacy benefits, PBM, or prescription coverage is preferred.

• Background in healthcare, insurance, benefits, prior authorization, claims, or member services is advantageous.

🏝️ Benefits

• Medical, dental & vision coverage.

• Critical Illness, Accident, and Hospital insurance.

• 401(k) Retirement Plan with options for Pre-tax and Roth post-tax contributions.

• Life Insurance (Voluntary Life & AD&D for employees and their dependents).

• Short and long-term disability coverage.

• Health Spending Account (HSA).

• Transportation benefits.

• Employee Assistance Program.

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