Pharmacy Benefit Coordinator
5 days ago
Responsibilities:
• Coordinate with new customers through all stages of pharmacy and medical/pharmacy combined benefits' implementation.
• Communicate effectively with the selected Pharmacy Benefit Manager (PBM) to provide initial set-up information.
• Collaborate with the Implementation Coordinator and Plan Documents Department to review the new customer’s Rx benefit structure.
• Prepare Rx plan design forms and supply any required documents to the PBM.
• Stay updated with the PBM's processes and requirements for new customer implementation.
• Ensure communication of any applicable Rx benefit information internally.
• Report any plan changes to the existing customer-selected PBM and ensure implementation of said changes.
• Identify and troubleshoot shared accumulator issues and communicate internally any applicable existing customer Rx benefit information or issues.
• Handle insurance-related tasks such as insurance billing, insurance follow-up, and understanding insurance coverage.
• Manage pharmacy claims and oversee both annual and contract renewals.• Proficient in managing Annual Renewals
• Experience with Contract Renewals
• Strong knowledge of Insurance procedures
• Ability to handle Insurance Billing efficiently
• Comprehensive understanding of Insurance Coverage
• Skilled in Insurance Follow-up procedures
• Familiarity with various Insurance Plans
• Expertise in Pharmacy Benefit Management
• Experience in Pharmacy Management
• Basic knowledge of Pharmacy operations
• Proficiency in handling Pharmacy Claims
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Pharmacy Benefits Coordinator Specialist
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