PBM Operations Analyst - Data Operations
October 29
Description
• Support the execution of all eligibility and accumulator operations. • Serve as day-to-day contact for all eligibility and accumulator needs. • Collaborates with technology, account management, benefit administration, and other internal stakeholders. • Oversee all downstream vendor feeds and third party integrations. • Configures benefits into the claim adjudication platform. • Develops and executes on test scenarios to ensure accuracy of benefit setup. • Performs research and troubleshoots inquiries or issues related to claims adjudication. • Ensures all documentation regarding setup and internal controls is always up to date.
Requirements
• Bachelor’s degree preferred. Relevant experience considered for exceptional candidates. • Pharmacy Technician or related experience highly desirable • 1-3 years of PBM experience in claims or benefit configuration
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