Remote Member Services Representative

Join PharmaCentra as a remote Member Services Representative and become the trusted first point of contact for members seeking support with pharmacy benefits, coverage questions, and account assistance. In this fully remote role, you will deliver compassionate, accurate service in a fast-paced call center environment while helping members navigate important healthcare needs.

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, healthcare, 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 (ET). 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.

Ready to Join Us? If you're detail-oriented and solution-driven with strong communication skills, we encourage you to apply now! Our 3-minute, mobile-friendly application process is quick and easy. We look forward to hearing from you!

**After applying, please complete the (1) Assessment and (2) Internet Speed Test to avoid processing delays. Candidates will be contacted using the email address and phone number provided.