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Benefits Specialist
Job
Insight Global
Pittsburgh, PA (In Person)
Full-Time
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Job Description
Job DescriptionJob Description A closed door pharmacy is looking to hire a Pharmacy Benefits Specialist. This role will include processing pharmacy claims, triaging rejected claims, and verifying benefits. Prior Pharmacy benefits experience is required as well as the ability to multitask.
Responsibilities:
- Process pharmacy claims accurately and timely to meet client expectations
- Triage rejected pharmacy insurance claims to ascertain patient pharmacy benefits coverage
- Maintain compliance with patient assistance program guidelines
- Document all information and data discovery according to operating procedures
- Research required information using available resources
- Maintain confidentiality of patient and proprietary information
- Perform all tasks in a safe and compliant manner that is consistent with corporate policies as well as State and Federal laws
- Work collaboratively and cross-functionally between management, the Missouri-based pharmacy, compliance and engineering
REQUIRED SKILLS AND EXPERIENCE
- High school diploma or GED required, Bachelor's degree strongly preferred
- One year of Pharmacy Experience, having resolved third party claims
- Healthcare industry experience with claims background
- Strong technical aptitude and ability to learn complex new software