[Hiring] Clinical Services Representative @PharmaCentra, LLC

Role Description

We are looking for a Clinical Services Representative to join our fully remote team. This position is an excellent opportunity for a healthcare professional who enjoys solving problems, working with healthcare information, and helping members, pharmacies, physicians, and clients resolve issues—without working in a traditional clinical setting.

The Clinical Services Representative provides support for:

• Clinical inquiries
• Prescription benefits
• Pharmacy claims
• Prior authorization information
• Claims-processing issues

You will work closely with:

• Members
• Pharmacies
• Healthcare providers
• Clients
• Internal team members

If you have experience with pharmacy, PBM, prescription claims, prior authorizations, clinical customer service, or healthcare operations, we'd like to hear from you.

Qualifications

• Strong analytical and problem-solving skills
• Excellent verbal and written communication skills
• Strong customer service and interpersonal skills
• Excellent attention to detail and accuracy
• The ability to research information and determine appropriate next steps
• The ability to multitask and prioritize competing demands
• The ability to work effectively in a fast-paced healthcare contact center environment
• Strong computer and data-entry skills
• The ability to learn and navigate multiple software applications
• Professional judgment and the ability to appropriately escalate issues
• Dependability, accountability, and reliable attendance
• The ability to work independently while contributing effectively as part of a remote team

Requirements

• Two-year college degree in a related field (preferred)
• Two or more years of applicable healthcare, pharmacy, PBM, insurance, claims, or customer service experience (preferred)
• Pharmacy or pharmacy-benefit experience (preferred)
• Experience with prescription claims processing or claims adjudication systems (preferred)
• Experience with prior authorization processes (preferred)
• Experience supporting members, pharmacies, physicians, or healthcare providers (preferred)
• Experience in a healthcare contact center or customer support environment (preferred)
• Knowledge of prescription benefits or pharmacy benefit management (preferred)
• Experience using Microsoft Word, Excel, PowerPoint, and Outlook (preferred)

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• Short-term and long-term disability coverage
• Life insurance
• Paid Time Off
• Paid holidays
• 401(k) retirement plan with company match
• DailyPay for eligible employees

Remote Work Requirements

• This is a 100% remote position and must be performed within the United States.
• Employees are responsible for providing and maintaining the equipment and internet connection necessary to perform the essential functions of the position.

Minimum Computer & Equipment Requirements

• Windows 10 or Windows 11, 64-bit computer
• Minimum 8 GB RAM
• Quad-core processor or better
• At least 50 GB of available storage
• Second monitor with minimum 1920 × 1080 resolution
• USB noise-canceling headset with microphone
• Webcam
• Keyboard and mouse
• Minimum of two USB-A ports
• Minimum of one HDMI port

Internet Requirements

• Minimum 50 Mbps download speed
• Minimum 50 Mbps upload speed
• Reliable internet connection capable of supporting continuous voice communication and required business applications

Schedule

• This is a full-time position of up to 40 hours per week.
• The regular operating schedule is Monday through Friday, with shifts scheduled through 10:00 PM Eastern Time.
• Occasional weekend coverage may be required based on business and client needs.
• Applicants must be able to work their assigned schedule consistently and maintain reliable attendance.

Equal Employment Opportunity

PharmaCentra LLC is an equal opportunity employer. Employment decisions are based on qualifications, merit, business needs, and other lawful considerations. PharmaCentra is committed to providing equal employment opportunities to qualified applicants and employees without regard to legally protected characteristics under applicable federal, state, or local law.

PharmaCentra complies with applicable laws regarding reasonable accommodations for qualified individuals with disabilities and sincerely held religious beliefs. Applicants who require an accommodation during the application or hiring process may contact Human Resources for assistance.

Apply today and join the PharmaCentra team!

Offer of employment is conditioned upon passing a background check.