Pharmacy Resolution Specialist

Job Summary

A company is looking for a Pharmacy Resolution Specialist to manage inquiries related to pharmacy benefits and prior authorization requests.

Key Responsibilities

• Respond to calls from members, providers, and pharmacies regarding benefit questions and prior authorization requests
• Research and resolve issues while logging and tracking inquiries in compliance with regulatory guidelines
• Maintain expert knowledge of pharmacy benefits and assist with prior authorization and appeal processes

Required Qualifications

• High School Diploma or GED
• Minimum of 1 year of experience in a call center or customer service role
• Knowledge of pharmacy and medical benefits
• Ability to work Monday to Friday from 10:30 a.m. to 7:00 p.m. EST
• Familiarity with CMS regulations related to pharmacy benefits