Pharmacy Adjudication Analyst
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Job Summary
Supporting the implementation and maintenance of pharmaceutical affordability programs, the full-time remote Pharmacy Adjudication Analyst will conduct quality control, investigate data discrepancies, and collaborate on complex issues to ensure operational accuracy and program integrity.
Key responsibilities
- Assist in the set-up and maintenance of affordability programs and adjudicated offerings
- Respond to and resolve business rule inquiries from internal teams and adjudicator partners
- Conduct quality control reviews on program setups and updates to ensure compliance with established standards
Required qualifications
- Bachelor's degree from a 4-year college or university or equivalent experience required
- Minimum 2-4 years of pharmacy technician or adjudication experience
- Knowledge of healthcare operations, claims processing, or rules-driven operational environments
- Understanding of quality control methodologies and issue investigation
- Familiarity with adjudication claims engines and relevant software tools
Complete Job Description
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