Clinical Appeals Pharmacist - Medicare Coverage

Apex Systems; Pittsburgh (Allegheny County); On-site; USD 70,000 - 90,000; Full time

Job summary

An IT staffing and services firm is seeking a Pharmacist to review clinical coverage determinations and appeals. The ideal candidate should be self-motivated with keen attention to detail and strong organizational skills. Responsibilities include conducting data analysis, managing medication exception requests, and ensuring compliance with quality standards. Candidates should have 2-5 years of experience and excellent verbal and written communication skills. Flexibility in scheduling for night, weekend, and holiday coverage is required.

Qualifications

• 2-5 years of experience in a relevant role.
• Ability to maintain patient confidentiality.
• Demonstrated resourcefulness in problem-solving.

Responsibilities

• Review clinical coverage determinations and appeals.
• Assist in meeting clients’ expectations for efficiency and quality.
• Complete data entry and analyze various clinical projects.

Skills

Self-motivated with strong attention to detail

Excellent verbal and written communication skills

Proficient computer skills in a Windows environment

Ability to work in a high-pressure environment

Strong organizational skills

Job description

An IT staffing and services firm is seeking a Pharmacist to review clinical coverage determinations and appeals. The ideal candidate should be self-motivated with keen attention to detail and strong organizational skills. Responsibilities include conducting data analysis, managing medication exception requests, and ensuring compliance with quality standards. Candidates should have 2-5 years of experience and excellent verbal and written communication skills. Flexibility in scheduling for night, weekend, and holiday coverage is required.