Jackson Pharmacy Professionals is currently recruiting for full-time Pharmacy Benefit Analyst
candidates in the Milwaukee area. We are actively interviewing and hiring for a full-time Monday-Friday permanent
position. Our ideal candidate will have 2+ years of Medical Claims processing experience. We are very interested in someone that is looking for their next career path, and would like opportunity to grow within the organization!
- Monday-Friday schedule, no nights or weekends required!
- Highly competitive compensation, salary up to $50K!
- Full-time, permanent opportunity!
- Room for growth within organization!
- Analyze standard and customized coding requests and work with internal teams to obtain the accurate and complete plan documentation needed to code client intent into the pharmacy claim adjudication system.
- Implement new and maintain existing benefit plans, pricing, and networks in the pharmacy claim adjudication system, consistent with the direction and intent set forth by the client
- Maintain the formularies and clinical program offerings in the pharmacy claim adjudication system.
- Perform pre- and post-implementation claim testing and other configuration quality reviews to ensure accurate claim adjudication and adherence to standard and custom design requirements
- Identify discrepancies, inaccuracies and unintended consequences, and take corrective action.
- Research and respond to claims processing and system configuration inquiries from internal departments.
- Proactively identify setup service issues and escalate to the experienced Benefit Coding Specialist for immediate review and resolution.
- Accurately configure non-adjudicated services and fees across multiple systems.
Pharmacy Benefit Analyst Qualifications:
- 2+ years of prior benefit analyst experience, preferably in the PBM setting
- 2+ years of prior PBM claims experience
- 2+ years of prior benefit contracting and pricing experience
- Knowledge of RxClaim system
If you are interested in this opportunity, please apply today for consideration!