[Remote] Pharmacy Customer Service Representative

Note: The job is a remote job and is open to candidates in USA. Rightway is on a mission to harmonize healthcare for everyone, everywhere. They are seeking a Pharmacy Customer Service Representative to handle pharmacy benefit inquiries, assist network pharmacies in processing claims, and serve as a customer advocate in problem resolution. Responsibilities • Handles calls and correspondence (electronic and written) regarding pharmacy benefit inquiries from providers (pharmacy/physician) and members. • Effectively communicate issues and resolution to members and providers. • Document calls within a call tracking system using established protocols to ensure resolutions are clear, concise, and accurate. • Assist network pharmacies in processing prescription claims. Review claims for accuracy against benefit guidelines and contract standards. • Serve as a customer advocate in problem resolution and follow through. • Creates and supports and environment which fosters teamwork, cooperation, respect and diversity. • Perform other duties and projects as assigned. Skills • Education level: Bachelor's Degree or equivalent relevant work experience. • Active/Current National Pharmacy Technician Certification • Work experience: 3-5 years of relevant work experience in a health plan, TPA or PBM contact center. • Important characteristics of ideal candidate: Detail-oriented, analytical, intellectually curious, good listener, empathetic, ability to challenge status quo, values exemplar • Specific skills needed for job: Prior experience working with health plan, TPA, or PBM contact center, effective & creative problem-solver, ability to prioritize and manage through change. • Solid communication skills. Company Overview • Rightway is a health technology company that is simplifying the healthcare experience for clients and members. It was founded in 2017, and is headquartered in New York, New York, USA, with a workforce of 501-1000 employees. Its website is http://rightwayhealthcare.com. Company H1B Sponsorship • Rightway has a track record of offering H1B sponsorships, with 2 in 2025, 3 in 2024, 1 in 2022, 2 in 2021. Please note that this does not guarantee sponsorship for this specific role. Apply tot his job Apply To this Job