Pharmacy Benefits/Insurance Claims Specialist (Medtech)

TL;DR

Pharmacy Benefits/Insurance Claims Specialist (Medtech): Processing and triaging pharmacy insurance claims to ensure patient coverage and accessibility of medications with an accent on claims accuracy, regulatory compliance, and cross-functional collaboration. Focus on resolving third-party claims, maintaining patient assistance program guidelines, and managing data discovery in a high-growth healthcare environment.

Location: Onsite in Boise, ID

Company

A fast-growing healthcare technology company building products to make prescriptions more accessible and affordable.

What you will do

• Process and triage pharmacy insurance claims accurately and timely to meet client expectations.
• Research and resolve rejected claims to determine patient pharmacy benefits coverage.
• Ensure strict compliance with patient assistance program guidelines and federal/state laws.
• Collaborate cross-functionally with management, the pharmacy team, compliance, and engineering.
• Document all data discovery and maintain strict confidentiality of patient and proprietary information.

Requirements

• Active Pharmacy Technician license or Pharmacy Technician in Training License in the state of Idaho.
• At least one year of pharmacy experience, specifically resolving third-party claims.
• Healthcare industry experience with a background in claims processing.
• High school diploma or GED required; Bachelor’s degree strongly preferred.
• Strong technical aptitude and ability to learn complex new software.
• Strong verbal and written communication skills with high attention to detail.

Culture & Benefits

• Comprehensive medical, dental, and vision insurance plans.
• 401(k) retirement plan.
• Daily snack stipend for the onsite marketplace.
• Pre-tax transit benefits and free onsite parking.
• Collaborative and innovative work environment dedicated to improving patient lives.