Care & Resolution Specialist (CPhT)

EmpiRx Health, LLC•Orlando, FL

10d•Onsite

About The Position

The Care & Resolution Specialist supports EmpiRx Health’s commitment to delivering white-glove, clinically driven member experiences. As a primary point of contact for complex member inquiries within Level 2 Member Services, the specialist ensures prompt, compassionate, and accurate resolution of escalated concerns. The role requires critical thinking, clinical awareness, and empathy, as well as collaboration with internal teams, pharmacies, and prescribers to provide a seamless, concierge-level service experience. The position is based in the EmpiRx Health Orlando office and is scheduled Monday through Friday, 8:30 a.m. to 5:00 p.m. Additional duties may be assigned, and the position may evolve to meet organizational needs.

Requirements

Active Pharmacy Technician Certification (CPhT) is required.
At least 2 years of experience in a PBM, health plan, or medication therapy management (MTM) call center, or 4 years of experience in a hospital or retail pharmacy setting.
At least 2 years of experience in a customer service-related field, preferably within healthcare or pharmacy.
Strong customer service orientation and commitment to concierge-level support.
Excellent verbal and written communication skills, including active listening and empathy.
Proficiency in Microsoft Office Suite and related systems such as CRM, ticketing, or case management tools.
Ability to think critically, solve problems, and make sound decisions under pressure.
Exceptional time-management and organizational skills, including the ability to manage multiple priorities in a fast-paced environment.
Collaborative mindset and ability to work cross-functionally to support resolution and client satisfaction.

Nice To Haves

Bachelor’s degree preferred.
Prior experience with benefit investigations, prior authorizations, or claims processing preferred.

Responsibilities

Respond promptly and professionally to inbound member calls and inquiries with empathy and precision.
Monitor and enforce adherence to established daily processes, protocols, and escalation pathways.
Act as an administrative liaison among members, internal departments, and external partners such as pharmacies and prescribers to facilitate timely solutions.
Manage and resolve cases involving prescription claims, authorizations, and other pharmacy benefit concerns, documenting outcomes according to departmental standards.
Apply sound judgment and empathy to develop effective, sustainable solutions for member issues.
Support urgent or emergency override situations according to defined protocols.
Maintain knowledge of pharmacy benefit workflows, claims adjudication procedures, plan setup, and client-specific benefit allowances.
Identify root causes of member issues and recommend process improvements.
Stay current on EmpiRx Health program updates, products, and processes to ensure accurate and compliant communication.
Collaborate with internal departments, including Clinical, Client Management, and Operations, to achieve timely, high-quality service outcomes.
Build trust and rapport with members through clear communication, transparency, and follow-up.
Maintain accurate records of member interactions, resolutions, and follow-ups in the member services system.
Participate in team huddles, performance reviews, and training sessions to support continuous improvement.
Perform additional duties as assigned in support of departmental and organizational goals.