Customer Support Specialist

ExactCare

Customer Support Specialist providing customer service in a timely manner for AnewHealth's pharmacy care management services. Must have experience in healthcare and pharmacy support.

Posted 6/17/2026full-timeRemote • Wisconsin • 🇺🇸 United StatesMid-LevelSeniorWebsite

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

claims adjudication softwareprior authorization requestsJIRApharmacy supportcustomer servicemanual claims processingreportingresearching rejected claimspharmacologyMedicare guidelines

Soft Skills

communication skillsprofessionalismproblem-solvingdecision-makingdetail-orientedprioritizationcustomer service orientationefficiencyinterpersonal skillsadaptability

Tools & Technologies

JIRAword processorsspreadsheetsdatabase softwareclaims softwaretelephone systemscall center technologycustomer relationship management (CRM)pharmacy management systemselectronic health records (EHR)

Certifications & Qualifications

CPhT (Certified Pharmacy Technician)Associate’s degree

Industry Keywords

healthcare industryMedicare Part Ddrug benefit concernsNDC issuesHIPAA guidelinesplan policiesbenefit structuresclient educationmedical terminologyfinancial terminology

About the role

Key responsibilities & impact

Answer telephone inquiries in a pleasant, professional, and efficient manner assuring exceptional customer service.
Document all incoming calls and dialogue in the claims adjudication software.
Educate clients on plan policies, benefits, and procedures.
Resolve client drug benefit concerns of a medical, financial, or technological nature.
Initiate and facilitate prior authorization requests.
Make outbound calls to pharmacies and plans to facilitate completion of JIRA tickets.
Review after hours calls log-complete any follow up as needed.
Submit JIRA tickets for compound prescriptions.
Submit JIRA tickets to resolve NDC issues (pricing issues, missing NDCs).
Stay current on plan and benefit structures, pharmacological updates, and Medicare Part D guidelines.
Accept other duties as assigned; including but not limited to direct member reimbursement, processing, manual claims, reporting, and researching rejected claims.
Ensures that HIPAA guidelines are followed in every communication with clients.

Requirements

What you’ll need

Associate’s degree or equivalent combination of education or work experience
CPhT (Certified Pharmacy Technician) Certification preferred
A minimum of 3 years of experience in customer service/member service in a call center or similar
A minimum of 2 years of experience in the healthcare industry
A minimum of 2 years of experience in a pharmacy support role
Knowledge of plan and benefit structures and Medicare guidelines.
Knowledge of pharmacology and pharmacological terms
Excellent communication skills and professionalism when working with clients
Ability to solve problems under pressure by making immediate decisions while on the phone
Detail oriented and able to prioritize workload
Strong computer skills including using word processors, spreadsheets, and database software.

Benefits

Comp & perks

Medical, dental and vision coverage effective 1st of the month following date of hire
Flexible spending
Company-paid life insurance and short-term disability
Voluntary benefits
401(k)
Paid Time Off
Paid holidays