Health Service Specialist

Claims Processing And Refill Specialist

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve we care.

What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you.

The Claims Processing And Refill Specialist plays a critical role in supporting patients' access to therapy by managing prescription refill requests, processing pharmacy claims, and coordinating resolution of reimbursement-related issues. This role serves as a liaison between patients, healthcare providers, pharmacies, payers, and internal teams to ensure timely medication access and continuity of care.

The ideal candidate will possess strong problem-solving skills, attention to detail, and the ability to navigate payer requirements, prescription processing workflows, and patient support services while delivering an exceptional customer experience. Working independently with minimal supervision, this position requires sound judgment, effective communication, and the ability to manage a high volume of cases in a fast-paced healthcare environment.

Location: This is a hybrid role and will require two days a week in office at our Cary, NC location.

Compensation: Target rate for this role is between $23 and $24 per hour.

Key Responsibilities

• Serve as a primary point of contact for patients, caregivers, healthcare providers, and other stakeholders participating in patient support programs.
• Provide program education, guidance, and ongoing support to help patients navigate treatment-related processes and available resources.
• Coordinate patient support services, ensuring timely completion of program activities and adherence to established guidelines.
• Facilitate communication between patients, providers, pharmacies, payers, and internal teams to help address barriers to care and therapy access.
• Support reimbursement and access-related activities, including benefit investigations, prior authorization coordination, patient assistance programs, and other program services.
• Conduct outbound and inbound calls to gather information, provide updates, and ensure patients receive the support needed throughout their treatment journey.
• Accurately document all interactions and case activities within web-based systems while maintaining compliance with company policies and regulatory requirements.
• Identify and escalate complex issues, patient concerns, or service-related challenges to the appropriate team members for resolution.
• Collaborate with cross-functional and multidisciplinary teams to improve patient experiences and program outcomes.
• Manage multiple cases and priorities while meeting quality, productivity, and service-level expectations.

Minimum Requirement

Typically requires 3+ years of related experience.

Critical Skills

• 3+ years of customer service, patient advocacy, or healthcare support experience.
• Excellent verbal and written communication skills with the ability to interact professionally with patients, providers, and healthcare stakeholders.
• Ability to build trust and maintain positive relationships with a diverse patient population.
• Strong problem-solving and critical-thinking abilities with the capacity to make sound decisions within established policies and procedures.
• Experience working with patient support programs, reimbursement services, healthcare access programs, specialty pharmacy, or related healthcare environments preferred.
• Proficiency with web-based systems, telephony platforms, and Microsoft Office applications.
• Exceptional organizational skills and attention to detail.
• Ability to manage a high-volume workload while maintaining accuracy and quality standards.
• Comfortable working independently with limited supervision and exercising judgment in routine and moderately complex situations.
• Knowledge of HIPAA, patient privacy regulations, and compliance requirements preferred.

The ideal candidate is a patient-focused professional who is passionate about helping individuals navigate the healthcare system and access the support they need. They are a strong communicator, thrive in a fast-paced environment, and can effectively manage multiple priorities while maintaining a high level of accuracy and professionalism. They are resourceful, collaborative, and committed to delivering an exceptional patient and provider experience.