Pharmacy Benefits Clinical Associate – Remote/Onsite

The-Occunet-Company-1; Amarillo (TX); Remote; USD 42,000 - 54,000; Full time

Benefits offered by this job

401(k) with matching

Health insurance

Vision insurance

Health savings account

Paid time off

Job summary

The OccuNet Company seeks a FairosRx Clinical Associate to support pharmacy benefit operations, coordinating clinical and administrative workflows, reviewing documentation, and communicating with members, providers, and staff. This on-site/remote role emphasizes accurate, timely processing of pharmacy benefit requests and service quality.

Responsibilities include prior authorizations, appeals, claims resolution, and formulary inquiries, with emphasis on HIPAA compliance and confidentiality.

Qualifications

• Strong communication and interpersonal skills for diverse audiences.
• Ability to multi-task and stay focused amid interruptions.
• PBM experience preferred.
• Team-oriented with motivation and drive.
• Experience in project collaboration and conflict resolution preferred.

Responsibilities

• Collect, verify, and document clinical information from providers, pharmacies, and members.
• Assist pharmacists with utilization management, coverage determinations, and appeals processing.
• Process claims and resolve adjudication issues.
• Support prior authorization case reviews and member services.
• Ensure HIPAA compliance and confidential handling of information.

Skills

Communication skills

Multitasking

PBM experience

Team collaboration

Project management

Education

High School Diploma or GED

Job description

The OccuNet Company seeks a FairosRx Clinical Associate to support pharmacy benefit operations, coordinating clinical and administrative workflows, reviewing documentation, and communicating with members, providers, and staff. This on-site/remote role emphasizes accurate, timely processing of pharmacy benefit requests and service quality.

Responsibilities include prior authorizations, appeals, claims resolution, and formulary inquiries, with emphasis on HIPAA compliance and confidentiality.