Pharmacy Resolution Specialist - Remote

Overview

The Pharmacy Resolution Specialist plays a crucial role in providing support to members, providers, and pharmacies by resolving inquiries related to pharmacy benefits and prior authorizations.

In Short

• Remote position available anywhere in the United States.
• Handles inbound and outbound calls to address pharmacy-related inquiries.
• Enters pharmacy overrides into systems based on clinical guidelines.
• Researches issues and takes appropriate actions to resolve them.
• Maintains expert knowledge on pharmacy benefits and formularies.
• Logs and tracks all inquiries and resolutions.
• Ensures compliance with regulatory and corporate guidelines.
• Assists with special projects as assigned.
• Requires High School Diploma/GED and 1 year of call center experience.
• Offers competitive pay and a comprehensive benefits package.

Requirements

• High School Diploma / GED.
• 1 year of job-specific call center or customer service experience.
• Strong attention to detail.
• Ability to handle multiple inquiries effectively.
• Knowledge of pharmacy benefits and CMS regulations.

Benefits

• Competitive pay.
• Health insurance.
• 401K and stock purchase plans.
• Tuition reimbursement.
• Paid time off plus holidays.
• Flexible work schedules.