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Pharmacy Insurance Specialist

3 months ago

Woonsocket, Rhode Island, United States Rose International Full time

Date Posted: 05/22/2024

Hiring Organization: Rose International

Position Number: 464531

Job Title: Pharmacy Insurance Specialist

Job Location: Woonsocket, RI, USA, 02895

Work Model: Hybrid

Shift: M-F 8:30-5

Employment Type: Temporary

Estimated Duration (In months): 10

Min Hourly Rate ($): 20.00

Max Hourly Rate ($): 23.00

Must Have Skills/Attributes: Billing, MS Excel, SQL

Job Description

Only those lawfully authorized to work in the designated country associated with the position will be considered.

Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client's business needs and requirements.

Position Summary

As a Pharmacy Insurance Specialist, you will be responsible for ensuring that all required third-party insurance settings are coded and maintained appropriately within the pharmacy adjudication system.

The Pharmacy Insurance Specialist will perform extensive testing and documentation to ensure accurate prescription claims processing while remaining in compliance with pharmacy standards and payer requirements.

As a part of the Network Operations team, this role allows you to analyze third-party programs, and investigate and resolve systemic issues relative to prescription claims processing that interfaces with stores, providers, patients, pricing, and financial impacts to the company.

Required Qualifications:

1+ year related experience in a pharmacy, PBM, or insurance position

1+ years of experience using Microsoft Word and Excel

Preferred Qualifications:

Pharmacy Technician Experience within the past 5 years

Previous experience with business-to-business, interdepartmental, or customer interactions

Retail Pharmacy help desk experience

Experience with SQL or Access

Education:

Verifiable High School Diploma or GED

Benefits:

For information and details on employment benefits offered with this position, please visit here. Should you have any questions/concerns, please contact our HR Department via our secure website.

California Pay Equity:

For information and details on pay equity laws in California, please visit the State of California Department of Industrial Relations' website here.