Rightway aims to make pharmacy benefits fair and transparent. This role is on the Operations team and serves as the first point of contact for members, providers, and pharmacies with questions about benefits, prior authorization, claims, and clinical program enrollment. You will work across phone, chat, and email to provide empathetic, timely support while applying root-cause problem solving.
What you'll do
Serve as the primary point of contact for members, providers, and pharmacies across phone, chat, email, and written correspondence.
Field and resolve inquiries related to mail order, benefit design, formulary coverage, medication cost, prior authorization criteria, and claims adjudication.
Assist network pharmacies in processing prescription claims and reviewing claims for accuracy against guidelines and contract standards.
Support clinical pharmacists with scheduling appointments, enrolling members in Rightway clinical programs, and following up on medication adherence.
Document interactions and resolutions in internal systems and coordinate with internal teams to ensure timely, complete resolutions.
Utilize AI-enabled tools and internal knowledge systems to resolve inquiries efficiently and maintain a consistent member experience.
What they're looking for
Associate or bachelor degree preferred, or equivalent relevant work experience.
Active current National Pharmacy Technician Certification (PTCB, NHA).
1 to 3 years as a pharmacy technician in a health plan, retail pharmacy, TPA, or PBM contact center; mail order and specialty backgrounds are a strong fit.
Working knowledge of pharmacy claims adjudication, benefit design, and PBM terminology.
Detail oriented, adaptable, and analytical, with the ability to dig past a symptom to find and resolve the true root cause.
For applicants in Nigeria
Hiring regions/eligibility: The listing does not specify Nigeria-specific eligibility; remote status is stated but no country restrictions are listed.
Timezone expectations: The listing does not state a timezone requirement; confirm before interviewing.
Contractor vs employee: The listing does not specify whether contractor or employee.
Pay currency/range: Pay is listed as $21.50 - $22.00 per hour.
Visa or work-authorization notes: The listing does not mention visa or work-authorization requirements.
Summarized by RemoteWork from the original listing. Always confirm details on the employer’s page.
Perks & benefits
What this listing says it offers, and who each perk covers. Perks limited to US or EU employees often do not reach contractors or people hired through an employer of record, which is how many hires from Nigeria are paid.
Pays in USD
$21.50–$22.00/hr compensation
Compensation offered is determined by geographic location, experience, and qualifications.
Not stated who it coversFrom this job listing
Ready to apply?
Your application goes straight to Rightway, on their own hiring page.