• Job Description

  Req#: 3365570

  Location: Hybrid (Local to NYC or Denver area)

  Position Summary:

  Capital Rx is looking for a results-driven Account Coordinator to support the PBA account teams, supporting Health Plan, TPA, and copay card clients. In this role, you will partner with account teams to enhance client satisfaction and help with day-to-day tasks. You’ll collaborate with internal teams to meet the needs of our clients and their members. If you’re passionate about building strong client relationships, navigating healthcare trends, and improving processes, we want to hear from you!

  Position Responsibilities:

  • Support implementation and client management teams with all day-to-day client requirements
  • Responsible for timely and accurate management and execution of all client benefit requests, including benefit changes, eligibility changes, and new implementations
  • Analyze incoming client requests and work with internal and external teams to complete required plan documentation
  • Support implementation of new plans, pricing, and networks, consistent with strategic or administrative intent
  • Lead pre- and post-implementation quality assurance and testing to validate coding accuracy
  • Lead claim reviews to proactively identify discrepancies or inaccuracies and develop solutions to address
  • Handle and resolve sponsor and member issues, escalating as needed
  • Research and respond to claims processing and system configuration inquiries
  • Coordinate integration of other data inputs into client management processes
  • Collaborate cross functionally to support general client operations, as required
  • Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.

  
  Required Qualifications:

  • Undergraduate bachelor’s degree, with record of strong academic performance or equivalent job experience
  • 1+ years of proven experience in PBM / health plan, benefits consulting, healthcare
  • Track record of building trusting internal and external relationships
  • Track record of leading cross-functional initiatives, driving high performance, meeting deadlines, and executing on deliverables
  • Experience working with structured and unstructured data
  • Proficient in Microsoft Office, SQL a bonus
  • Ability to balance multiple complex projects simultaneously
  • Exceptional written and verbal communication skills
  • Extremely flexible, highly organized, and able to shift priorities easily
  • Attention to detail & commitment to delivering high quality work product

  Base salary: $60,000 - $75,000

  This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

  About Capital Rx

  Capital Rx is a health technology company providing claim administration and technology solutions for carriers, health plans, TPAs, employer groups, and government entities. As a public benefit corporation, Capital Rx is executing its mission to materially reduce healthcare costs as a full-service PBM and through the deployment of Judi®, the company’s cloud-native enterprise health platform. Judi connects every aspect of the healthcare ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of benefits and rebuilding trust in healthcare.

  Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

• About the company

  On a mission to change the way prescription benefits are priced and administered in the US and rebuild trust in our healthcare system.

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