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California Pharmacy Resolution Specialist

7/9/2025

N/A

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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