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Pharmacy Benefit Analyst

Milwaukee, WI

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 benefit coding experience, preferably in the PBM setting. We are very interested in someone that is looking for their next career path, and would like opportunity to grow within the organization! 

Position Summary:
  • Monday-Friday schedule, no nights or weekends required!
  • Highly competitive compensation, salary up to $50K! 
  • Full-time, permanent opportunity!
  • Room for growth within organization! 

Position Details:
  • 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! 
Alyson Messegee
National Director
JPP - Jackson Pharmacy Professionals
My LinkedIn | Email | Referral Program
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