Member Advocate

The OccuNet Company

FairosRx Member Advocate supporting members, pharmacies, and physicians with pharmacy benefits. The OccuNet Company works to reduce healthcare costs and improve access.

Posted 8/21/2026full-timeAmarillo • Texas • 🇺🇸 United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in pharmacy benefit management, including handling inquiries related to formulary coverage, prior authorizations, and medication access. Strong communication and problem-solving skills are essential for effectively collaborating with members, pharmacies, and healthcare providers.

Highest-signal resume keywords

Pharmacy Benefit Management (PBM)Verbal And Written Communication SkillsMicrosoft Office ProficiencyActive ListeningProblem Solving

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

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

Hard Skills

Formulary CoveragePrior AuthorizationsClaim ProcessingMedication AccessData Verification

Soft Skills

Member-Focused MindsetTeam CollaborationTime ManagementOrganizational SkillsCritical Thinking

Tools & Technologies

Ticketing SystemPBM ToolsSoftware Applications

Industry Keywords

HIPAA ComplianceHealthcareInsuranceCustomer ServiceCall Center Experience

About the role

Key responsibilities & impact

Interact with members, pharmacies, and physicians to provide accurate information and support related to pharmacy benefits.
Handle inquiries by phone, chat, and email.
Assist with benefit questions, claim issues, medication access challenges, and pharmacy benefit experience.
Provide assistance regarding formulary coverage, copays, prior authorizations, and medication access.
Support pharmacies with claim processing questions or issues.
Work with providers on prior authorizations and drug coverage information.
Identify claims requiring action, initiate outbound outreach, and resolve issues efficiently.
Handle complex or sensitive cases and follow escalation pathways when needed.
Verify required data elements and adhere to HIPAA and internal privacy policies.
Navigate software, applications, and PBM tools.
Document interactions in the ticketing system.
Participate in call quality reviews, team discussions, and activities.
Collaborate with Clinical, Account Management, Operations, and other internal departments to research and resolve complex issues.

Requirements

What you’ll need

High school diploma or equivalent required.
Previous experience in pharmacy benefit management (PBM) is strongly preferred; pharmacy technician, healthcare, insurance, customer service, or call center experience highly valued.
Member-focused mindset with a passion for improving the member experience.
Highly effective verbal and written communication skills.
Demonstrates teamwork by collaborating effectively with peers and cross-functional teams to support member needs.
Strong computer skills, including Microsoft Office, with the ability to quickly learn new systems and technology.
Ability to multitask, manage time efficiently, and stay organized in a fast-paced, high-volume environment.
Excellent active listening, problem solving, and critical thinking skills.

Benefits

Comp & perks

401(k) with matching
Dental insurance
Health insurance
Vision insurance
Health savings account
Paid time off
High-growth environment with clear opportunities for career growth
Welcoming atmosphere and culture