Jersey City, NJ, United States
Nov 24, 2021
Mar 09, 2022
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.
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
Previous experience with pharmacy benefits management
Previous experience in project work (IT/Vendors, etc.)
Pharmacy Tech experience
Scheduled Weekly Hours
Website : http://www.humana.com