Pharmacy Benefits /Insurance Claims Specialist | Onsite- Pittsburgh

United States·Pittsburghmid

Legal & ComplianceClaims Specialist

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Requirements Summary

High school diploma or GED required, Bachelor’s degree strongly preferred One year of Pharmacy Experience,

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Legal & ComplianceClaims Specialist

~2 min read

✓Health, Dental & Vision – Multiple plan options from day 1

✓Well-being Support – Employee Assistance Program with counseling, wellness coaching, legal/financial advice, and more

✓Life & Disability Insurance

✓Commuter Benefits – Free onsite parking + pre-tax commuter FSA+ Free shuttle service

✓Free Snacks & Drinks

~1 min read

→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

~1 min read

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 verbal and written communication skills
Attention to detail and a strong operational focus
A passion for providing top-notch patient care
Ability to work with peers in a team effort and cross-functionally
Strong technical aptitude and ability to learn complex new software
Employees must hold all active licenses and registrations required for the role under applicable state law and as may be required by business necessity

On-site : 5 Penn Center Blvd, Robinson Township, Pittsburgh, PA
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 from10 AM- 6 PM
Availability for rotating Saturday shifts 9 AM- 5 PM (once a month)
Scheduling flexibility, as your schedule may change over time according to business needs