A company is looking for a Pharmacy Resolution Specialist who will handle inquiries and resolve issues related to pharmacy benefits.
Key Responsibilities
Responds to calls from members, providers, and pharmacies regarding benefit questions and prior authorization requests
Researches and resolves issues while logging and tracking all inquiries to meet performance standards
Maintains knowledge of pharmacy benefits and regulations, and assists with special projects as assigned
Required Qualifications
High School Diploma or GED
Minimum of 1 year of experience in a call center or customer service role
Knowledge of pharmacy and medical benefits
Ability to interpret CMS regulations related to pharmacy benefits
Experience with prior authorization processes and claims resolution
Resolution Specialist • Orlando, Florida, United States