Senior Pharmacy Claims Analyst

Job Summary

A company is looking for a Senior Business Systems Analysis Professional.

Key Responsibilities

• Serve as a subject matter expert for pharmacy COB processes and claims processing logic
• Analyze, monitor, and enhance processes and adjudication logic for pharmacy COB point-of-sale claims
• Lead projects related to process or logic changes across internal and external areas

Required Qualifications

• Proven experience with Coordination of Benefits (COB) processes and pharmacy claims adjudication
• Familiarity with CMS Prescription Drug Manuals and ability to interpret federal and state requirements
• 3-5 years of experience in data analysis and process optimization
• Proficiency in Microsoft Office applications (Access, Word, Excel, PowerPoint)
• Ability to manage multiple priorities and thrive in a fast-paced environment