Pharmacy Resolution Specialist

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 and tracks inquiries and complaints, ensuring compliance with regulatory guidelines and performance standards
• Maintains expert knowledge of pharmacy benefits and formulary regulations, while assisting with special projects as assigned

Required Qualifications

• High School Diploma or GED
• 1 year of experience in a call center or customer service role
• Knowledge of pharmacy and medical benefits
• Ability to work from 11:00 AM to 7:30 PM EST, Monday to Friday
• Experience with prior authorization processes is preferred