Pharmacy Benefits/Insurance Claims Specialist | Onsite- Boise
On-siteBoise, Idaho, United States
Job Summary
Process pharmacy claims accurately and timely, triaging rejected claims to ascertain patient coverage and maintaining compliance with patient assistance program guidelines. Document all data discovery per operating procedures while researching required information using available resources. Perform tasks in a safe, compliant manner consistent with corporate policies, state, and federal laws, ensuring confidentiality of patient and proprietary information. Collaborate cross-functionally between management, the Missouri-based pharmacy, compliance, and engineering teams. Requires Idaho Pharmacy Technician license or in-training license, one year of pharmacy experience resolving third-party claims, and a Bachelor's degree strongly preferred. Full-time onsite role in Boise, ID with rotating or fixed shifts including mandatory Saturday coverage every four weeks.
Required Qualifications
- High school diploma or GED
- Bachelor's degree
- One year of Pharmacy Experience
- Healthcare industry experience with claims background
- Strong verbal and written communication skills
- Attention to detail and a strong operational focus
- A passion for providing top-notch patient care
- Ability to work with peers in a team effort and cross-functionally
- Strong technical aptitude and ability to learn complex new software
- Must hold an active Pharmacy Technician license OR Pharmacy Technician in Training License in the state of Idaho, registered with the Idaho Board of Pharmacy
- Must be available for rotating shifts, 40 hours/week between 8 AM - 7 PM MST, Monday - Friday OR 10 AM - 6 PM MST, Monday - Friday (Fixed Shift) OR 11 AM - 7 PM MST, Monday - Friday (Fixed Shift)
- Must be available for 1 Saturday shift, every 4 weeks of 7 AM - 3 PM MST
- Must be able to attend Mandatory Training first 6 - 8 weeks from 8 AM- 4 PM MST
- Must be able to work onsite full time at 12639 W Explorer Dr #100, Boise, ID 83713
Desired Qualifications
- Bachelor's degree
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