Pharmacy Benefits Specialist (Healthcare)

TL;DR

Pharmacy Benefits Specialist (Healthcare): Processing and triaging pharmacy insurance claims to ensure patient benefit coverage with an accent on accuracy, compliance, and third-party claim resolution. Focus on resolving complex insurance rejections, documenting data discovery, and collaborating cross-functionally to streamline medication access.

Location: Fully On-site in Robinson Township, Pittsburgh, PA

Company

A healthcare technology company building products like BlinkRx and Quick Save to make prescriptions more accessible and affordable for everyone.

What you will do

• 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.
• Research and document all information and data discovery according to operating procedures.
• Work collaboratively and cross-functionally between management, pharmacy, compliance, and engineering.

Requirements

• Must be based in or be able to work onsite in Robinson Township, Pittsburgh, PA.
• One year of Pharmacy Experience, having resolved third party claims.
• Healthcare industry experience with a claims background.
• High school diploma or GED required; Bachelor’s degree strongly preferred.
• Strong verbal and written communication skills and attention to detail.
• Technical aptitude and ability to learn complex new software.

Culture & Benefits

• Medical, dental, and vision insurance plans.
• 401(k) retirement plan.
• Daily snack stipend for onsite marketplace.
• Pre-tax transit benefits and free onsite parking.
• Free shuttle service.