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
- Responds to calls from members, providers, and pharmacies regarding benefit questions and prior authorization requests
- Logs, tracks, and resolves inquiries while adhering to regulatory and quality standards
- Maintains expert knowledge of pharmacy benefits and assists with special projects as assigned
Required Qualifications
- High School Diploma or GED
- 1 year of experience in a call center or customer service role
- Knowledge of pharmacy and medical benefits
- Ability to work between the hours of 9:30 AM-6 PM EST, Monday-Friday
- Familiarity with CMS regulations related to pharmacy benefits
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