Highmark Health
Pharmacy Coordinator
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Job Description
- Req#: J273822
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Salary up to $23.72
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to make a positive impact on patient care and medication management
- Comprehensive training and development programs available
What to Expect (Job Responsibilities):
- Provide effective guidance to front-line staff to ensure efficient delivery of pharmacy call center services
- Respond to inquiries from physicians and pharmacy network providers regarding medication requests and claim edits
- Review member claims history to assess medical necessity for non-formulary and prior authorization requests
- Document all authorizations and denials accurately in accordance with regulatory timelines
- Participate in onsite member appeals and grievances sessions as a pharmacy representative
What is Required (Qualifications):
- High school diploma or GED
- Experience in pharmacy prescription claims processing, submission, and payment
- Strong organizational skills and attention to detail
- Excellent interpersonal and communication skills
- Ability to work efficiently in a fast-paced, multi-task environment
How to Stand Out (Preferred Qualifications):
- Associate degree
- Pharmacy technician certification
- Experience in managed care medication formulary management
- Familiarity with Medicaid and Medicare drug benefit design offerings and regulations
- Strong background in medications and formulary terminology
#HealthcareServices #Pharmacy #CareerOpportunity #CompetitivePay #TrainingProvided
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