Remote Medicare Customer Service Representative II (Work From Home) Remote (USA) | CST & EST Candidates Preferred
$21.13/hour (W2)
Full-Time | 12+ Month Contract
Job Description
We are hiring Remote Medicare Customer Service Representatives (Representative II) to support one of the nation's leading healthcare organizations. In this role, you'll assist Medicare members, providers, and prescribers by processing coverage-related requests, handling inbound/outbound calls, and completing case documentation in a fast-paced, production-driven environment.
This is a 100% remote opportunity for candidates with customer service, healthcare, Medicare, pharmacy, PBM, or call center experience.
Responsibilities
- Handle inbound and outbound customer service calls.
- Process Medicare Part D coverage determinations, prior authorizations, and appeals.
- Review and document member cases accurately.
- Contact members and providers to obtain missing information.
- Navigate multiple computer systems while maintaining productivity and quality standards.
- Meet CMS compliance and company performance metrics.
- Work independently in a remote environment.
Minimum Qualifications
- High School Diploma or GED
- At least 6 months of experience in:
- Customer Service
- Call Center
- Healthcare
- Pharmacy
- Medicare
- PBM
- Medical Office
- Strong computer and data entry skills
- Ability to multitask across multiple applications
- Excellent communication skills
- Ability to work independently in a production-driven environment