Position Type: Remote (Contract)

Contract Duration: October 30, 2026 – April 2, 2027

Pay Rate: $21.00/hour ($22.00/hour with active PTCB or ExCPT Pharmacy Tech Certification)

Equipment: IT equipment provided

Position Overview

We are seeking dedicated, empathetic, and detail-oriented Customer Experience / Member Advocates to join a fast-paced pharmacy benefit team for the upcoming peak season. In this role, you will serve as the primary point of contact for health plan members, prescribers, and pharmacies. Acting in a "concierge" capacity, you will focus on high-quality interactions rather than call handle times—helping callers navigate prescription eligibility, prior authorizations, and general pharmacy benefit inquiries with clarity and care.

Key Responsibilities

• Handle inbound and outbound calls, emails, and chat inquiries from members, pharmacies, and healthcare providers (avg. 30–50 calls per day).

• Assist callers with prescription eligibility, claim processing, prior authorizations, and general benefit questions.

• Serve as a liaison between members, pharmacies, and prescribers to resolve coverage and access issues promptly.

• Research complex inquiries across multiple database systems while maintaining clear, accurate, and concise documentation.

• Provide concierge-level support by practicing active listening, empathy, and effective de-escalation tactics on challenging calls.

• Collaborate with internal team leads, clinical staff, and operations to optimize the overall caller experience.

Work Environment & Schedule Requirements

• Training Hours: Monday – Friday, 8:00 AM – 5:00 PM

• Regular Department Hours: Monday – Friday, 7:00 AM – 9:00 PM

• Shift Availability: Candidates must be flexible to work standard 8-hour shifts starting between 7:45 AM and 10:45 AM (based on 1-hour or 30-minute lunch options).

• Remote Setup Requirements:

  • A dedicated, quiet, distraction-free home office space.

  • Reliable high-speed broadband internet (minimum 80–100 Mbps download / 10–20 Mbps upload; wired connection strongly preferred).

  • Ability to work independently with minimal daily supervision and strong time management skills.

Qualifications

Required:

• At least 1 year of customer service experience (call center or healthcare administrative background preferred).

• Strong computer proficiency, including hands-on experience with Microsoft Office Suite (Word, Excel, Teams) and the ability to learn complex software systems quickly.

• Exceptional verbal and written communication skills with demonstrated de-escalation abilities.

• High dependability, strong attendance record, and self-directed work ethic.

Preferred:

• Prior experience in Pharmacy Benefit Management (PBM), retail pharmacy, or health insurance call centers.

• Knowledge of prescription benefits, claim processing, and prior authorization workflows.

• Active Pharmacy Tech Certification (PTCB or ExCPT) or state licensure.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

^*As a job position within our Allied division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: providing direct patient care, accessing medical and confidential records, accessing and administering prescription medication or other drugs, working within a clinical setting, handling sharp instruments, conducting medical procedures, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.