Pharmacy Benefits/Insurance Claims Specialist

Job Description

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We have a great opportunity for an on-site Pharmacy Benefits/Insurance Claims Specialist in Pittsburgh, PA

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We are a highly collaborative team of builders and operators who invent new ways of working in an industry that historically has resisted innovation. Join us!

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This is a fully On-site role in Robinson Township, Pittsburgh

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Responsibilities:

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• Process pharmacy claims accurately and timely to meet client expectations
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• Triage rejected pharmacy insurance claims to ascertain patient pharmacy benefits coverage
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• Maintain compliance with patient assistance program guidelines
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• Document all information and data discovery according to operating procedures
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• Research required information using available resources
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• Maintain confidentiality of patient and proprietary information
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• Perform all tasks in a safe and compliant manner that is consistent with corporate policies as well as State and Federal laws
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• Work collaboratively and cross-functionally between management, the Missouri-based pharmacy, compliance and engineering
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Requirements:

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• High school diploma or GED required, Bachelor's degree strongly preferred
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• One year of Pharmacy Experience, having resolved third party claims
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• Healthcare industry experience with claims background
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• Strong verbal and written communication skills
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• Attention to detail and a strong operational focus
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• A passion for providing top-notch patient care
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• Ability to work with peers in a team effort and cross-functionally
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• Strong technical aptitude and ability to learn complex new software
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• Employees must hold all active licenses and registrations required for the role under applicable state law and as may be required by business necessity
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Location/Hours

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• On-site : 5 Penn Center Blvd, Robinson Township, Pittsburgh, PA
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• 40 hrs/week, rotating shifts 8 AM- 9 PM OR fixed shifts of 12 PM- 8 PM OR 1 PM- 9 PM
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• Mandatory Training first 6 -8 weeks from10 AM- 6 PM
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• Availability for rotating Saturday shifts 9 AM- 5 PM (once a month)
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• Scheduling flexibility, as your schedule may change over time according to business needs
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Benefits

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• Health, Dental & Vision Multiple plan options from day 1
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• Well-being Support Employee Assistance Program with counseling, wellness coaching, legal/financial advice, and more
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• Life & Disability Insurance
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• Commuter Benefits Free onsite parking + pre-tax commuter FSA+ Free shuttle service
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• Free Snacks & Drinks
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