Majid Nawaz

Manpower

Our client is seeking an experienced Pharmacy Claims &amp; Benefits Specialist to support members, providers, and insurance carriers by verifying eligibility, resolving prescription issues, and ensuring accurate claims processing in a fast-paced pharmacy environment.Schedule<ul><li>Monday &ndash; Friday | 11:30 AM &ndash; 8:00 PM</li><li>Occasional Saturdays &amp; required overtime</li><li>Remote role with potential 1&ndash;2 days onsite ( Plymouth MI, Tempe, AZ or North Canton, OH)</li></ul>Key Responsibilities<ul><li>Verify insurance eligibility and prescription benefits</li><li>Process prescriptions and support claims adjudication</li><li>Communicate with providers, payers, pharmacies, and members to resolve billing or prescription issues</li><li>Coordinate with PBMs and pharmacists</li><li>Maintain accurate documentation and meet productivity/quality goals</li><li>Escalate complex issues as needed</li></ul>Qualifications<ul><li>Must reside within 45 miles of Plymouth MI, Tempe, AZ or North Canton, OH</li><li>High School Diploma required; degree preferred</li><li>Active State Pharmacy Technician license (in Michigan or Ohio)</li><li>National certification (PTCB or NHA)</li><li>1-2 years of pharmacy experience</li><li>Experience with claims adjudication, Medicaid, secondary billing, or discount cards preferred</li><li>Strong communication, attention to detail, and ability to work in a high-volume environment</li><li>Proficiency in Microsoft Office and pharmacy systems</li></ul>Pay: $20.50 per hourBenefits:<ul><li>401(k)</li><li>Dental insurance</li><li>Employee assistance program</li><li>Health insurance</li><li>Referral program</li></ul>Work Location: Hybrid remote in Plymouth, MI 48170

Pharmacy Claims & Benefits Specialist (Remote)

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Pharmacy Claims & Benefits Specialist (Remote)