On-Site Clinical Operations Specialist

EmpiRx Health; Montvale (NJ); On-site; USD 51,000 - 64,000; Full time

Benefits offered by this job

Paid Time Off

401(k) plan

Health Insurance including Dental &amp

Vision coverage

Tuition Reimbursement

Health Savings Account

Employee Assistance Program

Job summary

EmpiRx Health in Montvale, NJ is seeking a Clinical Operations Specialist to support adjudication, PA, and clinical review teams on-site five days a week. The role requires at least five years of pharmacy experience, including two years in claims adjudication and two years in prior authorization, with PBM experience preferred.

Proficiency in MS Office and strong attention to detail are essential. You will help ensure timely processing and collaborate across departments to deliver white-glove

Qualifications

• Proficiency in Microsoft Office Suite.
• Exceptional attention to detail and organizational skills.
• Strong customer service orientation and interpersonal skills.
• Demonstrated ability to meet tight deadlines and manage multiple tasks efficiently.
• Strong critical thinking and problem-solving capabilities.
• Must be able to work on-site five days per week.

Responsibilities

• Provide administrative support to adjudication, PA, and clinical review teams.
• Process claim overrides and case documentation per SOPs.
• Maintain turnaround times and quality metrics for members/clients.
• Collaborate with clinical pharmacists and operations for case handling.
• Monitor case queues and SLA adherence for escalation.
• Maintain confidentiality and professional communication.

Skills

MS Office

Attention to detail

Customer service

Multitasking

Critical thinking

On-site work

Education

High school diploma

Job description

EmpiRx Health in Montvale, NJ is seeking a Clinical Operations Specialist to support adjudication, PA, and clinical review teams on-site five days a week. The role requires at least five years of pharmacy experience, including two years in claims adjudication and two years in prior authorization, with PBM experience preferred.

Proficiency in MS Office and strong attention to detail are essential. You will help ensure timely processing and collaborate across departments to deliver white-glove