California Licensed Pharmacy Specialist

Job Summary

A company is looking for a Pharmacy Resolution Specialist.

Key Responsibilities

• Receives and responds to calls from members, providers, and pharmacies regarding benefit questions and prior authorization requests
• Logs, tracks, and resolves inquiries and complaints while adhering to regulatory and corporate guidelines
• Maintains expert knowledge of pharmacy benefits and formularies, ensuring accurate communication and resolution of claims

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 interpret CMS regulations related to pharmacy benefits
• Experience in handling inquiries and complaints in a timely manner