Senior Specialist, Pharmacy Systems Operations - Remote

Role responsibilities

Serve as a pharmacy systems coding subject matter expert for Prior Authorization, focusing on medical drug claim processing and appeals. Collaborate with various stakeholders to ensure accurate claims processing and implement solutions for automation and system integration.

Requirements

A bachelor's degree is required along with 4-6+ years of relevant experience in claims processing or pharmacy. Candidates should have proficiency in MS Office and experience in a healthcare environment.

Key skills

Claims Processing, Pharmacy, Utilization Management, Technical Support, File Transfer Systems, System Integration, Automation, Test Strategies, Communication, Attention to Detail, Problem Solving, Data Analysis, MS Office, Reporting Systems, Root Cause Analysis, Collaboration

Keywords

Pharmacy Systems, Prior Authorization, Medical Drug Claims, Utilization Management, Claims Processing, Technical Support, File Transfer Systems, System Integration, Automation, Test Strategies, MS Office, SAS, Oracle, Communication Skills, Attention to Detail, Problem Solving, Data Analysis