Pharmacy Resolution Specialist

Job Summary

A company is looking for a Pharmacy Resolution Specialist to handle member and provider inquiries related to pharmacy benefits.

Key Responsibilities

• Responds to calls from members, providers, and pharmacies regarding benefit questions and prior authorization requests
• Logs and resolves inquiries and complaints while adhering to regulatory and corporate guidelines
• Maintains knowledge of pharmacy benefits and assists with prior authorization and coverage determination processes

Required Qualifications

• High School Diploma or GED
• 1 year of job-specific call center or customer service experience
• Knowledge of pharmacy and medical benefits
• Ability to work Monday - Friday, 10:30 a.m. to 7:00 p.m. EST
• Experience in handling inquiries and complaints in a timely manner