Pharmacy Benefits Specialist

Responsibilities:

• Process pharmacy claims accurately and timely to meet client expectations


• Triage rejected pharmacy insurance claims to ascertain patient pharmacy benefits coverage


• Maintain compliance with patient assistance program guidelines


• Document all information and data discovery according to operating procedures


• Research required information using available resources


• Maintain confidentiality of patient and proprietary information


• Perform all tasks in a safe and compliant manner that is consistent with corporate policies as well as State and Federal laws


• Work collaboratively and cross-functionally between management, the Missouri-based pharmacy, compliance and engineering

Requirements:

• High school diploma or GED required, Bachelor’s degree strongly preferred


• One year of Pharmacy Experience, having resolved third party claims


• Healthcare industry experience with claims background


• Strong verbal and written communication skills


• Attention to detail and a strong operational focus


• A passion for providing top-notch patient care


• Ability to work with peers in a team effort and cross-functionally


• Strong technical aptitude and ability to learn complex new software


• Employees must hold all active licenses and registrations required for the role under applicable state law and as may be required by business necessity