Pharmacy Benefit Specialist
CareOregon
full-time
Posted on:
Location Type: Remote
Location: Oregon • Washington • United States
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Salary
💰 $21 - $25 per hour
Job Level
About the role
- working with CareOregon members, their providers, and pharmacies to support the pharmacy benefit and prescription needs under the major medical benefit
- customer service and claims processing
- assistance with prior authorizations, formulary exceptions, appeals, grievances, and projects
Requirements
- Minimum 1 year work experience on a pharmacy team (i.e., retail, long-term care, or hospital) or 1 year experience in a health insurance plan
- General understanding of managed care, Medicare, and Oregon Health Plan concepts
- Proficient with Microsoft Office Products and general computer literacy
- Familiarity with medical and pharmaceutical terminology
- Ability to learn and effectively navigate CareOregon and PBM software programs necessary to perform job responsibilities
- Ability to follow policies and procedures in performing job responsibilities
- Effective listening, verbal, and written communication skills
- Ability to exercise professionalism
- Ability to focus on and comprehend information
- Ability to learn new skills and abilities
- Ability to accept managerial direction and feedback
- Ability to tolerate and manage stress
- Results and service oriented
- Ability to be flexible and adaptable
- Ability to organize, plan, and prioritize daily workflow within time constraints
- Ability to work in an environment with diverse individuals and groups
- Ability to learn, focus, understand, and evaluate information and determine appropriate actions
- Ability to accept direction and feedback, as well as tolerate and manage stress
- Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day
- Ability to hear and speak clearly for at least 3-6 hours/day
Benefits
- medical, dental, vision, life, AD&D, and disability insurance
- health savings account
- flexible spending account(s)
- lifestyle spending account
- employee assistance program
- wellness program
- discounts
- multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings)
- strong retirement plan with employer contributions
- accrue PTO and Paid State Sick Time
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claims processingprior authorizationsformulary exceptionsappealsgrievancesmedical terminologypharmaceutical terminologycomputer literacyMicrosoft Office
Soft Skills
effective listeningverbal communicationwritten communicationprofessionalismfocusadaptabilityorganizationplanningprioritizationstress management