Pharmacy Resolution Specialist

Job Summary

A company is looking for a Pharmacy Resolution Specialist who will manage inquiries and resolve issues related to pharmacy benefits.

Key Responsibilities

• Respond to calls from members, providers, and pharmacies regarding benefit questions and prior authorization requests
• Research and resolve issues while logging and tracking inquiries to meet performance standards
• Maintain knowledge of pharmacy benefits and regulations, and assist with prior authorization and appeals processes

Required Qualifications

• High School Diploma or GED
• One year of experience in a call center or customer service role
• Knowledge of pharmacy and medical benefits
• Ability to work between the hours of 10AM-7PM EST, Monday-Friday
• Familiarity with CMS regulations related to pharmacy benefits