Pharmacy Resolution Specialist

Job Summary

A company is looking for a Pharmacy Resolution Specialist to handle inquiries related to pharmacy benefits and prior authorization requests.

Key Responsibilities

• Receive and respond to calls from members, providers, and pharmacies regarding benefit questions and prior authorization requests
• Research issues thoroughly and take appropriate actions to resolve them while adhering to regulatory and corporate guidelines
• Maintain expert knowledge of pharmacy benefits and formularies, ensuring compliance with CMS regulations

Required Qualifications

• High School Diploma or GED
• 1 year of job-specific call center or customer service experience
• Must be authorized to work in the U.S. without the need for employment-based visa sponsorship
• Availability to work from 9:30 AM to 6:00 PM EST
• Ability to comply with all policies and standards