Pharmacy Reimbursement Administrator

Job Summary

A company is looking for an Administrator, Pharmacy Reimbursement.

Key Responsibilities

• Administers technical processes for system price setups, electronic funds transfers, and remittance setups
• Ensures compliance and oversight reporting on the end-to-end claims process and implements necessary controls
• Conducts pharmacy network rate testing, analysis, and quality assurance to ensure accurate claims adjudication

Required Qualifications

• Associate Degree preferred or equivalent experience; CPhT preferred
• Experience in PBM or managed care is preferred, but not required
• Previous testing experience is preferred
• Commitment to compliance program objectives
• Ability to interact cooperatively and respectfully with other employees