Highmark Health
10,000+ employees
Founded 1852
🛡️ Insurance
💼 Consulting
📦 Logistics
💰 $5M Grant on 2021-05
Insurance • Consulting • Logistics
Highmark Health is a healthcare company committed to reinventing the healthcare system and improving its services for everyone. The organization offers a broad range of career opportunities across various fields such as clinical care, technology, finance, and marketing. Highmark Health emphasizes diversity, equity, and inclusion in its workforce, creating a supportive environment for employees from all backgrounds. The company has been recognized for its commitment to disability inclusion, diversity, and military-friendly employment. As an independent licensee of the Blue Cross Blue Shield Association, Highmark Health strives to create remarkable healthcare experiences for its customers and employees alike.
Pharmacy Coordinator
Job not on LinkedIn
🕒 July 20
⚜️ Louisiana, North Carolina, +3 more states – Remote
💵 $19 - $24 / hour
⏰ Full Time
🟡 Mid-level
🟠 Senior
💊 Pharmacist
🦅 H1B Visa Sponsor
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Highmark Health
10,000+ employees
Founded 1852
🛡️ Insurance
💼 Consulting
📦 Logistics
💰 $5M Grant on 2021-05
Insurance • Consulting • Logistics
Highmark Health is a healthcare company committed to reinventing the healthcare system and improving its services for everyone. The organization offers a broad range of career opportunities across various fields such as clinical care, technology, finance, and marketing. Highmark Health emphasizes diversity, equity, and inclusion in its workforce, creating a supportive environment for employees from all backgrounds. The company has been recognized for its commitment to disability inclusion, diversity, and military-friendly employment. As an independent licensee of the Blue Cross Blue Shield Association, Highmark Health strives to create remarkable healthcare experiences for its customers and employees alike.
📋 Description
• Provide front line staff guidance • Ensure effective and efficient delivery of Pharmacy call center services • Respond to physician and pharmacy network provider inquiries concerning medication requests and drug claim edits • Review member claims history for medical necessity of non-formulary medication exception requests • Interact with pharmacy network providers to address denied prescription claim transitions • Document all authorizations and denials completely and accurately • Participate in onsite member appeals and grievances sessions
🎯 Requirements
• Minimum High school diploma or GED • Experience in pharmacy prescription claims processing/submission/payment • Preferred Associate degree • Pharmacy technician certification certificate • Experience working in a managed care medication formulary management environment • Working knowledge of retail pharmacy and/or third party prescription processing • Strong background and understanding of medications and formulary terminology • Must be familiar with multiple Medicaid drug benefit design offerings and rules/regulations across multiple states • Must also be familiar with Medicare drug benefit design offerings that may differ by state.
🏖️ Benefits
• Health insurance • Retirement plans • Paid time off
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