Patient Copay Support Representative

Job Description

Job Description

Job Summary

Our client is seeking a dedicated Support Representative to serve as frontline support for patients, caregivers, pharmacies, and physician offices. This role involves managing a high volume of inbound calls to assist with prescription costs and access programs, ensuring eligible patients receive necessary financial assistance and support.

Key Responsibilities

• Handle approximately 50-60 inbound calls per day with an average talk time of 6-7 minutes.
• Act as frontline support for patients, caregivers, pharmacies, and physician offices regarding prescription costs and access programs.
• Screen patients for eligibility and enroll them in manufacturer copay cards and financial assistance programs.
• Answer inquiries regarding copay card balances, annual maximums, expirations, and activations.
• Contact payers and PBMs to obtain benefit details, patient responsibility, and deductible/coinsurance amounts.
• Research and troubleshoot common pharmacy claim rejections (e.g., refill-too-soon, coordination of benefits).
• Track and coordinate status updates on pending Prior Authorizations (administrative support only; no clinical determinations).
• Chronologically document all interactions and claim activities in the CRM/case management system under HIPAA compliance.

Qualifications

• 1+ year healthcare experience.
• Solid understanding of basic healthcare/insurance concepts (copays, deductibles, coinsurance, OOP maximums, PBMs).
• Strong phone handling / customer service skills.
• Desire to be in a call center role.

Experience

• 1+ year in healthcare.
• 1-2 years in a pharmacy billing contact center, retail pharmacy, or medical front office is preferred.
• Health plan customer service / member services experience is preferred.

Skills

• Solid understanding of basic healthcare/insurance concepts (copays, deductibles, coinsurance, OOP maximums, PBMs).
• Strong phone handling / customer service skills.
• Proficiency in CRM/case management systems for documentation.

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.

Company Description

Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.

Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?

Company Description

Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.\r\rOur commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?