Remote Member Services RepresentativePharmaCentra, LLC • New York, New York, United States
Remote Member Services Representative
PharmaCentra, LLC
- New York, New York, United States
- New York, New York, United States
Über
What You'll Do
Handle 40+ inbound calls daily with professionalism, empathy, and efficiency
Respond to member inquiries within service standards
Educate members on benefits, coverage, claims, and plan processes
Assist with prior authorizations, formulary exceptions, and appeals
Research and resolve issues using multiple systems in real time
Accurately document all interactions in CRM and internal systems
Escalate complex concerns while maintaining ownership of the member experience
Participate in training, coaching, team huddles, and performance improvement initiatives
Follow HIPAA/privacy standards, quality guidelines, and company procedures
What We're Looking For
Education: High School Diploma or equivalent.
Experience: 1+ year of customer service, member services, health care, or call center experience; pharmacy benefits, managed care, claims, or healthcare experience preferred.
Skills: Ability to manage high call volumes in a fast‑paced environment. Strong communication, active listening, and customer service skills. Experience with claims processing and prior authorizations preferred. Detail‑oriented with strong problem‑solving skills and the ability to multitask across multiple systems.
Technical Skills: Proficiency in Microsoft Office (Excel, Word, PowerPoint, Outlook), CRM, or contact center platforms.
Required Equipment: Windows 10/11 PC (Intel i5/AMD Ryzen 5+, 8 GB RAM, 256 GB SSD), webcam, noise‑canceling headset (no Mac or Chromebooks).
Benefits
Competitive pay and growth opportunities.
Fully remote with flexible scheduling.
DailyPay for daily wage access.
Comprehensive benefits (medical, dental, vision, disability, life insurance), PTO, and paid holidays after 90 days.
401(k) with company match after 1 year of service.
Work Schedule
Full‑time, 40 hours/week
Training typically lasts two weeks, with sessions held Monday to Friday, 10 AM to 6 PM Eastern Time. After training, you will be assigned a fixed schedule, which will remain consistent unless there are changes to business needs or personal requirements.
Employees work 8‑hour shifts between 12 PM and 10 PM ET Monday through Friday, with a requirement to work one weekend day per week during the same hours.
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Sprachkenntnisse
- English
Hinweis für Nutzer
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