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

• 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