Pharmacy Benefits Specalist

Required Skills & Experience

• 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 technical aptitude and ability to learn complex new software

Job Description

A closed door pharmacy is looking to hire a Pharmacy Benefits Specialist. This role will include processing pharmacy claims, triaging rejected claims, and verifying benefits. Prior Pharmacy benefits experience is required as well as the ability to multitask.

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