Job Description
Job Title: Representative II(Medicare Operations)
Job Location: 100% Remote
Job Duration: 8 Months + Extension Start Date: 10/05/2026
Shift: Training Hours are 8a-4:30p CST. Working hours will be a rotating shift between the hours of 7a-8p CST Questioners:
1. Attendance is extremely important, especially during the initial 8 weeks of training. The new hire must be available M-F from 8am-4:30pm CST for the first 8 weeks (no vacation time planned). All time off needed should be discussed and disclosed during this initial review. Do you have any conflicts with the training schedule or time off planned during assignment duration?
2. After training, our hours of operation are 7a-8p CST M-F with rotating weekend schedules. they must be available for the rotating weekend. Do you have any conflicts working an assigned 8-hour shift between 7AM 8PM CST and rotating weekends?
3. This is a work from home (WFH) position; must have a dedicated quiet, separate space in which to work with wired internet meeting 25mbps min download and 5mbps minimum upload speed. Previous WFH experience is preferred. Do you have a separate workspace with no interruptions?
Please include internet speed
4. Must be able to sit and focus on work for the duration of shift. Are you able to sit and focus with no interruptions for entire shift?
5. Data entry and navigating multiple computer applications while utilizing two screens is the primary function of job (possible outbound calls needed). A job history demonstrating this is recommended. Do you have data entry experience?
6. Pharmacy or medical background is preferred. Do you have a Pharmacy or Medical background?
7. Successfully worked independently in a data entry, productivity driven role is preferred Are you able to work independently?
8. As a company we strive for a team that is engaged and positive so candidates that demonstrate this would be ideal Do you feel you have the engagement and positive attitude to work this assignment?
Position Summary: - As a Rep II, Operations, you will support Medicare members, prescribers, and providers by processing coverage-related requests across both phone and fax (offline) channels.
- This role integrates responsibilities previously segmented by channel (phone vs. fax) and line of business (Medicare Part D and applicable Medicare Part B processes), reflecting the organization's modularized training model in which colleagues progressively learn, practice, and apply end to end skills before fully transitioning to production work.
- In this role, you will be responsible for accurate case setup, review, outreach, documentation, and timely resolution of requests in accordance with Medicare guidelines, CMS-mandated timelines, and internal quality standards.
- You will demonstrate strong attention to detail, professional verbal and written communication skills, and the ability to problem-solve in a highly regulated, fast-paced environment.
- Work will be performed through a combination of inbound and outbound phone interactions and fax-based casework.
- This position is full-time, remote (Work at Home), non-exempt, and requires schedule flexibility based on business needs.
Schedule and Work Environment Schedule: - Flexibility to work shifts between 7:00am 8:00pm CST (Monday Friday) and rotating weekend or holiday coverage as required by business needs.
- Overtime and extended hours may be required during peak periods.
Work Environment: - Remote, work-from-home position.
- Dedicated, secure, and quiet home workspace required.
- Reliable high-speed internet with ability to hard-wire into company equipment (NO wireless connection, NO hotspots).
Essential Functions and Physical Requirements: - Regular and predictable attendance.
- Ability to work mandatory overtime or extended workweeks when required.
- Ability to sit for extended periods at a computer workstation.
- Ability to type and use a mouse throughout the duration of the shift.
Role Context (Training Model Alignment): - This role reflects an integrated Rep II model aligned with modularized training.
- Colleagues are trained across both phone and fax-based workflows and progressively apply learned skills through practice before full production deployment.
- Channel assignment (phone vs. offline work) and case mix may vary based on business needs, proficiency, and operational demand.
- Any remaining discrepancies between legacy role definitions (phone vs. fax, Part D vs. Part B) can be addressed individually without altering the core scope of this position.
- Opportunity for full-time employment contingent on performance
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Job Tags
Full time, Remote work, Monday to Friday, Shift work, Rotating shift