PBM prescription claim Analyst - BCBS of Arizona

Job TitleInterview: Onsite Visa: USC and GC Hybrid: Phoenix, AZ (need local) JD:Job Description:Analyze PBM prescription claim and other applicable systems for medication benefit quality and accuracySupport internal and external customers with information on benefits applicable to medication claimsPerform, evaluate, and assist in defining and improving the quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines.Administer, interpret, and maintain current working knowledge of required BCBSAZ systems, procedures, forms and manualsCommunicate recommendations in regard to medication claim processing and benefit decisions.Monitor and investigate reported plan set up system issuesParticipates in quality initiatives; including functions that support audits, reporting, evaluation of quality opportunities and concerns, and creation and implementation of corrective actions as requested.Resolve escalated member issuesResearch & provide recommendations for accumulations issuesLogs all benefit setup issues on error tracking reportsIdeal Candidate Profile Experience:Highly preferred: 3-4 years of experience with Rx claims or PBM (Pharmacy Benefit Management)Background in medical claims or related fieldTechnical Skills:Strong Excel or Excel-like tool proficiencyVLOOKUPsFiltering and updating spreadsheetsUsing basic formulas in spreadsheetsComfortable handling large datasets quickly and accuratelyNice to Have:Data entry experience with an analytical mindsetExperience in Rx claim/PBM work