Pharmacy Assistant - Systems

Independent Health • Buffalo, NY

17d • $22 - $25

About The Position

The Pharmacy Assistant-Systems shall be responsible for working multiple daily and weekly member and system maintenance reports. Additional tasks will include producing reports, manual claim reimbursements, eligibility files, MAC appeals, MSP claims, before reports, provider blocks, reversals, DMR’s, and PKU claims. The Pharmacy Assistant must possess the ability to work independently on all assigned daily and weekly tasks. Occasional evenings, weekends, holidays and overtime will be a requirement of the position.

Requirements

• High school diploma or GED required.
• One (1) year of pharmacy experience required.
• Ability to research member eligibility and interpret pharmacy plan benefits to ensure timely and accurate payment of pharmacy claims.
• Excellent written and verbal communication skills required.
• Flexibility to work holidays, weekends, evening shifts, or overtime required.
• Proven examples of displaying the PBD values: Trusted Advisor, Innovative, Excellence, Guardianship, Dedication and Caring.

Nice To Haves

• Claims data entry experience preferred.

Responsibilities

• Formulary administration to include preparing reports for pharmacists and system team members to review.
• Complete regularly scheduled formulary changes.
• Research and process member submitted manual claims, transfer to appropriate parties when necessary, and provide communications to members and pharmacies for outcomes.
• Utilize procedures or tip sheets to process claims appropriately and within set time frames.
• Complete system configuration and testing for MAC appeals and weekly MAC updates.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED