Pharmacy Support Specialist

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.


Job Summary


Our client is seeking an experienced Pharmacy Support Specialist to join their rapidly growing organization with a unique business model. The role will primarily involve serving as the central point of contact for specialty pharmacies, analyzing claim rejections, and providing accurate guidance for issue resolution.


Key Responsibilities

• Pharmacy Advocacy & Triage: Serve as the central point of contact for specialty pharmacies; investigate inquiries regarding claim underpayments and route them to the appropriate internal team for resolution.
• Claims Troubleshooting: Analyze pharmacy claim rejections and denials to provide pharmacies with accurate guidance on next steps without performing direct re-billing.
• Queue & Relationship Management: Monitor Program Support queues and Tableau reports to ensure all pharmacy partner inquiries are acknowledged and addressed within a 95% accuracy standard.
• Process Optimization: Identify recurring "pain points" in pharmacy inquiries to notify leadership of opportunities for system improvements or new provider training materials.

Skills

• Pharmacy Billing & Claims Proficiency: Deep understanding of the pharmacy claim lifecycle, specifically the ability to interpret NCPDP rejection codes.
• Specialty Medication Workflow: Experience within a Specialty Pharmacy, PBM, or Hub environment, with knowledge of how Prior Authorizations and clinical documentation impact drug dispensing.
• High-Volume Digital Triage: Ability to manage a high-volume queue with 95% accuracy, demonstrating strong written communication skills.

Additional Requirements


Schedule: 8am-4:30pm, Monday to Friday


Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Required Employment / Compliance Language


Medix provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color,


* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).


Medix Overview:


With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.


* As a job position within our Allied division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: providing direct patient care, accessing medical and confidential records, accessing and administering prescription medication or other drugs, working within a clinical setting, handling sharp instruments, conducting medical procedures, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.