Job Description

Pharmacy Benefit Specialist

Manchester, NH

Our client is hiring for a Pharmacy Benefit Specialist to join their growing team in Manchester, NH. Our client is an organization that provides health benefits to Union members and their families. They also are the pharmacy benefit manager for multiple health and welfare funds and cover thousands of lives.

Requirements of the Pharmacy Benefit Specialist:

• 3 years of customer service experience in a service-based organization.
• Strong organizational and time-management skills, with the ability to learn new tasks quickly and effectively.
• Professional and pleasant phone etiquette, with a passion for excellence in customer support and success in teamwork.
• Skilled at composing thorough and personalized responses to questions.
• Ability to manage frequent interruptions and respond appropriately to unexpected situations with poise and without frustration.
• Have a calm and professional demeanor and can excel at deescalating a challenging caller.
• A strong mastery of common Microsoft products such as Word, Excel and Outlook and the ability to quickly learn new software systems.
• A high school diploma or equivalent required. Associate or Bachelor’s Degree preferred.
• Experience in Pharmacy, medical or healthcare insurance strongly desired, but we will train the right candidate.

Benefits of the Job:

• Full-time, hourly wage of $24.00 to $31.25, equating to $50k to $65k annually.
• Pension – with a 100% vested schedule after 5 years.
• Employer Paid Health insurance.
• Employer Paid Dental insurance.
• Employer Paid Vision insurance.
• 401(k) with match
• Generous Paid time off

Responsibilities of the Pharmacy Benefit Specialist:

• Compile and summarize clinical data for review by our Clinical Pharmacist.
• Generate, format, and summarize standard claims data extracts using reporting tools and Microsoft Excel.
• Download clinical data from our pharmacy partner’s database.
• Assist retail pharmacies with claims adjudication.
• Effectively resolve questions and concerns in a considerate, professional, and timely manner using a variety of communication channels (phone, email, web).
• Interpret and explain prescription, deductible, out of pocket benefits to members.
• Take full ownership of any follow-up required to thoroughly address members’ questions or concerns, such as researching claim-related information with third-party vendors.
• Develop and maintain an effective tracking system to ensure that nothing falls through the cracks.
• Document every member interaction in benefit administration system to ensure the member’s record is up to date with all relevant information.
• Master the details of the various benefit plans to ensure you can provide timely and accurate information to member inquiries.
• Spot any trends in member issues and flag for the rest of the team.

KMA Human Resources Consulting has been engaged to manage this search. NO PHONE CALLS OR RECRUITERS PLEASE

Our client is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, ancestry, familial status, age, physical or mental disability, pregnancy, sexual orientation, gender identity, genetic information, veteran status, or any other characteristic protected by law.

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