Pharmacy Resolution Specialist

Job Summary

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

Key Responsibilities

• Receive and respond to calls from members, providers, and pharmacies regarding benefit questions and prior authorization requests
• Research and resolve issues while logging and tracking all inquiries and complaints according to regulatory and corporate guidelines
• Maintain expert knowledge of pharmacy benefits and formularies, and assist with special projects as assigned

Required Qualifications

• High School Diploma or GED
• 1 year of job-specific call center or customer service experience
• Ability to work Monday to Friday from 11:00 AM to 7:30 PM EST
• Knowledge of pharmacy and medical benefits
• Experience in handling prior authorization and coverage determination processes