Customer Service Representative

Role overview Handle calls and written requests about prescription prior authorizations, providing clear and courteous support to members, providers, and pharmacies. The work combines customer service, accurate information processing, coordination with internal teams, and escalation of clinical questions to pharmacists.

Responsibilities - Respond to incoming calls and process faxed and electronic authorization requests; make outbound calls and monitor shared mailboxes as needed. - Manage a busy queue while navigating multiple systems and maintaining professional communication. - Follow applicable procedures and requirements when reviewing information and communicating authorization status or results. - Coordinate with pharmacists, appeals teams, and other internal partners. - Recognize clinical questions and route them to the pharmacist team.

Requirements - High school diploma or GED. - At least one year of experience resolving complex customer needs in a high-volume phone support role. - Strong computer, keyboarding, email, web navigation, and basic office-suite skills; able to use several applications at once. - Clear, professional communication, attention to detail, and the ability to learn, adapt, and solve problems.

Nice to have - Pharmacy technician license or trainee registration in Arizona, and an active PTCB or NHA certification. - Familiarity with pharmaceutical terminology, calculations, and protocols; experience in a pharmacy, medical office, hospital, or retail setting. - Prior remote work experience.

Benefits and work setup - Full-time remote work requires high-speed internet connected by cable to a router or modem, a private and distraction-free workspace, and dependable care arrangements during working hours. Some employees living within 50 miles of a worksite may need transportation for occasional on-site support. - The schedule is 40 hours per week, any day Monday through Sunday between 8 a.m. and 9 p.m. Eastern; a set schedule is assigned after training. Training lasts five weeks, Monday through Friday, 7 a.m. to 3:30 p.m. Mountain, with full attendance required. - Eligible benefits include medical, dental, and vision coverage, paid time off, retirement savings options, and wellness programs. A pharmacy technician certificate apprenticeship may be available after training.