A company is looking for a Pharmacy Resolution Specialist who will handle inquiries and resolve issues related to pharmacy benefits.
Key Responsibilities
Receive and respond to calls from members, providers, and pharmacies regarding benefit questions and prior authorization requests
Log, track, and resolve inquiries and complaints while adhering to regulatory and corporate guidelines
Maintain expert knowledge of pharmacy benefits and formularies, and assist with special projects as assigned
Required Qualifications
High School Diploma or GED
One year of job-specific call center or customer service experience
Knowledge of pharmacy and medical benefits
Ability to interpret CMS regulations related to pharmacy benefits
Experience in handling prior authorization and coverage determination processes
Pharmacy Specialist • Salem, Oregon, United States