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Pharmacy Resolution Specialist

5/21/2025

Not specified

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 corporate guidelines
  • Maintains expert knowledge of pharmacy benefits and assists with special projects as assigned
Required Qualifications
  • High School Diploma or GED
  • 1 year of job-specific call center or customer service experience
  • Knowledge of pharmacy and medical benefits
  • Ability to work from 10:30 AM to 7:00 PM EST, Monday through Friday
  • Capable of interpreting CMS regulations as they pertain to pharmacy benefits

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