Pharmacy Customer Service Representative

Remote Pharmacy Customer Service Representative

100% Remote |

Start Date:

August 10, 2026

Location Requirement

Candidates must reside in one of the following states:

+ Florida

+ Georgia

+ Maryland

+ New Jersey

+ North Carolina

+ Pennsylvania

+ South Carolina

+ Texas

About the Role

We're seeking compassionate and detail-oriented Pharmacy Customer Service Representatives to support Medicare members with prescription drug coverage and pharmacy benefit questions. This is a high-volume, customer-focused role where you'll assist members, providers, pharmacies, brokers, and internal teams with pharmacy-related inquiries and issue resolution.

Many calls involve members who are experiencing barriers to accessing medications, making it essential to listen carefully, research solutions, explain benefits clearly, and guide callers through the appropriate next steps. Representatives must be comfortable handling sensitive situations with empathy, professionalism, and a strong commitment to customer service.

Top Skills We're Looking For

+ Pharmacy, prescription benefits, or Medicare knowledge

+ High-volume customer service or call center experience

+ Active listening, empathy, and de-escalation skills

+ Strong problem-solving and multitasking abilities

Key Responsibilities

+ Respond to inbound calls regarding Medicare pharmacy benefits, prescription coverage, pharmacy claims, and plan information.

+ Assist members, providers, pharmacies, brokers, and internal teams with pharmacy-related questions and issue resolution.

+ Research and resolve inquiries using internal systems, vendor applications, plan documents, and knowledge resources.

+ Review and interpret pharmacy benefit information, policies, and coverage requirements to provide accurate guidance.

+ Document all customer interactions accurately and thoroughly.

+ Escalate complex issues and coordinate with internal teams or vendors as needed.

+ Maintain compliance with HIPAA, Medicare, and organizational policies.

+ Meet quality, productivity, schedule adherence, and customer satisfaction goals.

+ Participate in ongoing training and coaching to stay current on pharmacy benefits, Medicare programs, and internal processes.

Required Qualifications

+ High School Diploma or GED.

+ Previous customer service or call center experience.

+ Strong verbal and written communication skills.

+ Ability to explain complex information clearly and professionally.

+ Strong attention to detail and accuracy.

+ Comfortable navigating multiple systems while assisting callers.

+ Ability to work independently and collaboratively in a team environment.

+ Reliable attendance and commitment to a performance-driven work environment.

Preferred Qualifications

+ Pharmacy Technician experience strongly preferred.

+ Medicare, Medicare Part D, pharmacy benefits, PBM, or prescription coverage experience.

+ Healthcare, insurance, benefits, claims, prior authorization, or member services experience.

What to Expect

This is a fast-paced, high-volume call center environment supporting Medicare pharmacy benefit inquiries. Representatives regularly assist callers with:

+ Prescription coverage and cost questions

+ Pharmacy claims and benefit inquiries

+ Plan rules and coverage requirements

+ Prior authorization-related concerns

+ Medication access issues and pharmacy support

Many calls are time-sensitive and may involve members who are currently at a pharmacy attempting to fill a prescription. Successful candidates remain calm under pressure, actively listen, research solutions, and clearly communicate next steps.

Work Environment

+ 100% remote, phone-based customer service role

+ Structured and performance-driven environment

+ Metrics include quality, productivity, customer service, schedule adherence, and reliability

+ Private, secure workspace required to maintain HIPAA compliance

+ Remote work cannot be used as a substitute for childcare or caregiving responsibilities

Schedule & Training

Schedule:

+ Flexible to work a 7.5-hour shift between 8:00 AM - 8:00 PM EST

+ Availability required seven days per week based on business needs

+ Mandatory overtime may be required

Training:

+ Approximately 6-8 weeks

+ Monday-Friday, 8:00 AM - 4:15 PM EST

+ Camera-on participation required

+ Successful completion of training assessments required

Why Apply?

This is an excellent opportunity to join a leading health plan organization and build expertise in Medicare pharmacy benefits, healthcare operations, customer service, and problem-solving. You'll gain valuable experience supporting members through important healthcare decisions while making a meaningful impact on their access to medications and care.

Job Type & Location

This is a Contract position based out of Tampa, FL.

Pay and Benefits

The pay range for this position is $19.00 - $20.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for…