Job added in hotlist
Applied job
Contract job
Recruiter job
Employer job
Expanded search
Apply online not available
Similar Jobs
View more jobs in Jersey City, NJ
View more jobs in New Jersey

Job Details

Pharmacy Claims Professional 2

Company name
Humana Inc.

Jersey City, NJ, United States

Employment Type


Posted on
Nov 24, 2021

Valid Through
Mar 09, 2022

Apply for this job



The Pharmacy Claims Professional 2 monitors and ensures appropriate adjudication of pharmacy claims. The Pharmacy Claims Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.


The Pharmacy Claims Professional 2 analyzes and answers inquiries regarding pharmacy claims adjudication(benefits and eligibility), including method of payment, co-pay or deductible amounts, and/or reason for denial. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

Required Qualifications

At least 2 years of data analysis & problem solving skills

Comprehensive knowledge of all Microsoft Office applications, including Access, Word, Excel and PowerPoint

Strong verbal and written communication skills, including the ability to tailor communication to audience

Strong organizational and time management skills

Ability to handle multiple tasks, meet deadlines, and follow-up timely

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

Previous experience with pharmacy benefits management

Claims experience

Previous experience in project work (IT/Vendors, etc.)

Pharmacy Tech experience

Additional Information

Scheduled Weekly Hours


Company info

Humana Inc.
Website :

Similar Jobs:
Financial Analyst II/Senior Financial Analyst
Location : New York City, NY
Aon is looking for a Financial Analyst II/Senior Financial AnalystWe currently have an exciting career opportunity for a Financial Analyst II/Senior Financial Analyst in our New York office (preferable). This position will suppo...
Business Development Manager (Insurance)
Location : New York City, NY
Company Details\n\n\nBerkley One exists to insure and protect the lifestyles of a modern generation of affluence. We seek clients that are sophisticated individuals and families who require world-class risk and claims management ...
Commercial Insurance Underwriter
Location : New York City, NY
Description\nThe Commercial Auto Underwriter builds relationships to drive consistent target submissions in order to price, sell and retain a profitable book of business. You will analyze, evaluate, rate and price within rate fili...
The number of jobs listed on EmploymentCrossing is great. I appreciate the efforts that are taken to ensure the accuracy and validity of all jobs.
Richard S - Baltimore, MD
  • All we do is research jobs.
  • Our team of researchers, programmers, and analysts find you jobs from over 1,000 career pages and other sources
  • Our members get more interviews and jobs than people who use "public job boards"
Shoot for the moon. Even if you miss it, you will land among the stars.
InsurCrossing - #1 Job Aggregation and Private Job-Opening Research Service — The Most Quality Jobs Anywhere
InsurCrossing is the first job consolidation service in the employment industry to seek to include every job that exists in the world.
Copyright © 2022 InsurCrossing - All rights reserved. 169 192