Job Summary
A company is looking for a Pharmacy Resolution Specialist.
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 prior authorization and appeal 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 between the hours of 11:30 AM-8 PM EST, Monday-Friday
- Familiarity with CMS regulations related to pharmacy benefits
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