Job Description
Pharmacy Benefits Specialist (Customer Service Rep)
Make an impact every day by helping members navigate their pharmacy benefits with confidence. We’re looking for a detail-driven, customer-focused professional who thrives in a fast-paced environment and enjoys solving complex problems. If you excel at multitasking, mentoring others, and delivering exceptional service—this role is for you.
What You’ll Do
In this role, you’ll serve as both a pharmacy claims expert and a customer service specialist, handling a high volume of calls (40–50 per day during peak seasons) while ensuring accurate claims processing and exceptional member support.
Key Responsibilities:
+ Adjudicate pharmacy claims quickly and accurately, ensuring compliance with plan guidelines
+ Handle inbound calls from members, providers, employer groups, and internal teams
+ Educate callers on benefit coverage, utilization, and administrative processes
+ Process a variety of pha...
Make an impact every day by helping members navigate their pharmacy benefits with confidence. We’re looking for a detail-driven, customer-focused professional who thrives in a fast-paced environment and enjoys solving complex problems. If you excel at multitasking, mentoring others, and delivering exceptional service—this role is for you.
What You’ll Do
In this role, you’ll serve as both a pharmacy claims expert and a customer service specialist, handling a high volume of calls (40–50 per day during peak seasons) while ensuring accurate claims processing and exceptional member support.
Key Responsibilities:
+ Adjudicate pharmacy claims quickly and accurately, ensuring compliance with plan guidelines
+ Handle inbound calls from members, providers, employer groups, and internal teams
+ Educate callers on benefit coverage, utilization, and administrative processes
+ Process a variety of pha...