Pharmacy Benefits Specialist at DME Service… · Location…

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