Job Summary
The Pharmacy Claims Adjudication Specialist plays a key role in processing pharmacy claims, addressing third-party rejections, and facilitating the accurate coordination of benefits. This position also entails managing communications with patients concerning medication delivery issues and serving as a point of contact for inquiries related to financial responsibilities.
Responsibilities
- Adjudicate pharmacy claims effectively.
- Resolve rejections from third-party entities.
- Ensure precise coordination of benefits for patients.
- Assist patients with inquiries about medication delivery delays.
- Act as a liaison for questions regarding financial responsibilities.
Qualifications
- High School Diploma or GED is required.
- A minimum of 2 years of experience in a pharmacy or healthcare environment.
- Proficiency in pharmacy billing and insurance processes.
- Strong analytical and effective communication skills.
