Benefits Specialist

Job Description

Job Description

Pharmacy Benefits Specialist (Insurance Claims)

Location: Pittsburgh (Robinson Township)

Pay Rate: $21/hr-$23/hr

Must Haves:

• High school diploma or GED required, Bachelor’s degree strongly preferred
• One year of Pharmacy Experience, having resolved third party claims OR Healthcare industry experience with claims background
• Strong technical aptitude and ability to learn complex new software

Day-to-Day:

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

Exact compensation may vary based on several factors, including skills, experience, and education.
Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.