Eligibility Representative – Accredo – Remote

About This Opportunity

We are representing a confidential specialty pharmacy organization seeking an Eligibility Representative for a fully remote position. Our client serves patients who require complex medication therapies, and this role is essential to ensuring smooth coordination between patients, insurance providers, and clinical teams.

In this position, you will verify medical and pharmacy benefits, resolve coverage issues, and help patients navigate the often-complicated insurance landscape for specialty medications. Every interaction requires attention to detail, problem-solving skills, and genuine empathy for patients managing serious health conditions.

Responsibilities

• Perform medical and pharmacy benefit verification by contacting insurance companies or accessing provider portals to confirm drug coverage and benefits
• Facilitate cross-functional resolution of coverage issues and proactively research obstacles to timely patient onboarding
• Coordinate services to ensure reimbursability, including verification of deductibles, co-payments, effective dates, authorization requirements, and levels of care
• Conduct day-of-shipment insurance reviews to confirm criteria are met for reimbursement and minimize bad debt risk
• Collaborate effectively with internal departments to resolve issues, maintaining professional communication standards at all times
• Exercise discretion and independent judgment when handling patient or complex complaints, escalating to leadership when appropriate
• Complete additional projects and duties as assigned

What We're Looking For

• High school diploma or GED required; bachelor's degree preferred
• 2+ years of relevant working experience
• Healthcare or professional office experience with medical insurance knowledge and terminology strongly preferred
• Experience in patient access is a plus
• Pharmacy or specialty pharmacy experience is advantageous
• Proficiency in Microsoft Office (Word, Outlook, Excel)
• Excellent written and oral communication skills, including phone presentation abilities
• Ability to adapt in a dynamic work environment and make decisions with minimal supervision
• Strong problem-solving skills and collaborative mindset for working across departments
• Reliable home internet connection via cable broadband or fiber optic with minimum speeds of 10Mbps download/5Mbps upload

Schedule Details:

• Training: Monday–Friday, 8:00 AM – 5:00 PM CST for 12 weeks
• Post-training: Monday–Friday, 10:00 AM – 7:00 PM CST

How We Work with You

Get A Job.ai represents top employers seeking exceptional talent. When you apply through our platform, one of our experienced recruiters will review your qualifications and conduct an initial screening. If you're a strong match, we will submit your profile to our client for consideration. Please do not contact the employer directly—all communication and coordination will be managed by our talent team to ensure the best experience for you.

Pay

This position is eligible for annual bonus participation. Our client also offers a comprehensive benefits package starting day one, including medical, vision, dental, well-being programs, 401(k), company-paid life insurance, tuition reimbursement, a minimum of 18 days paid time off annually, paid holidays, and various leave options.

Equal Employment Opportunity: Get A Job.ai is committed to inclusive hiring practices. We welcome applicants of all backgrounds and do not discriminate on the basis of race, color, age, disability, sex, sexual orientation, gender identity, veteran status, religion, national origin, or any other protected characteristic.