Pharmacy Benefit Configuration Specialist
Job Summary
Working remotely on a contract basis, the Pharmacy Benefit Configuration Specialist will manage ticketing systems, adjudicate benefits across multiple software platforms, and assist with Pharmacy Network setups while ensuring compliance with established procedures.
Key responsibilities
- Manages assigned tickets within a ticketing system and resolves issues in the Adjudication queues promptly
- Adjudicates benefits for clients, following Standard Operating Procedures for new and existing programs
- Communicates with various teams to clarify benefit designs and ensures proper documentation for claims processing
Required qualifications
- 2+ years of experience in a Pharmacy Benefit Manager (PBM) environment using a claims processor
- Intermediate or advanced proficiency in MS Excel, Word, PowerPoint, and Outlook
- High school diploma or equivalent
- Ability to adapt to new technologies and learn quickly
- Experience in claim research and benefit design or configuration
Complete Job Description
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