Pharmacy Benefit Specialist (Customer Service Rep)

TEKsystems•Murray, UT

6d•$21 - $21•Onsite

About The Position

Pharmacy Benefits Specialist (Customer Service Rep) Make an impact every day by helping members navigate their pharmacy benefits with confidence. We’re looking for a detail-driven, customer-focused professional who thrives in a fast-paced environment and enjoys solving complex problems. If you excel at multitasking, mentoring others, and delivering exceptional service—this role is for you. In this role, you’ll serve as both a pharmacy claims expert and a customer service specialist, handling a high volume of calls (40–50 per day during peak seasons) while ensuring accurate claims processing and exceptional member support.

Requirements

Strong customer service mindset with exceptional communication skills
Ability to multitask and stay organized in a high-volume environment
Critical thinking and problem-solving skills under pressure
Confidence navigating multiple systems and technologies simultaneously
High attention to detail and commitment to accuracy

Nice To Haves

Pharmacy Benefit Specialist I certification or Pharmacy Technician Certification (active or expired)
Experience in pharmacy benefits, healthcare support, or claims processing

Responsibilities

Adjudicate pharmacy claims quickly and accurately, ensuring compliance with plan guidelines
Handle inbound calls from members, providers, employer groups, and internal teams
Educate callers on benefit coverage, utilization, and administrative processes
Process a variety of pharmacy benefit scenarios including: Coordination of Benefits (COB), Direct Member Reimbursements (DMR), Coinsurance and mail-order prescriptions
Enter claim overrides with precision and meet audit quality standards
Maintain detailed and accurate member documentation
Resolve complex issues efficiently while delivering top-tier customer service
Meet and exceed performance metrics for call volume, response time, and quality