Pharmacy Benefits Specialist

Position: Pharmacy Benefits Specialist

Location: Pittsburgh (Robinson Township) - Pittsburgh, PA 15276

Duration: 6 month Contract-To-Hire

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
• 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

Schedule Details:

• 40 hrs/week, rotating shifts 8 AM- 9 PM OR fixed shifts of 12 PM- 8 PM OR 1 PM- 9 PM
• Mandatory Training first 6 -8 weeks from 10 AM- 6 PM
• Availability for rotating Saturday shifts 9 AM- 5 PM (once a month)

Compensation: $21/hr to $23/hr. Exact compensation may vary based on several factors, including skills, experience, and education. Employees in this role will enjoy a comprehensive benefits package starting on day one of employment, including options for medical, dental, and vision insurance. Eligibility to enroll in the 401(k) retirement plan begins after 90 days of employment. Additionally, employees in this role will have access to paid sick leave and other paid time off benefits as required under the applicable law of the worksite location.