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Pharmacy Resolution Specialist

7/9/2025

N/A

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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