Pharmacy Benefits Operations Specialist

Beacon Hill; Raleigh (NC); On-site; USD 42,000 - 65,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

Leave programs

Job summary

Beacon Hill is seeking an Intake Specialist to support pharmacy benefit operations in a healthcare environment in Raleigh, NC. You will coordinate pharmacy-related requests, research and resolve escalated issues, and collaborate with PBM partners and internal teams.

The role emphasizes strong communication, research, and organizational skills with multi-tasking ability. Qualified candidates have a high school diploma or GED and 3+ years of related experience, preferably in health insurance, PBM,

Qualifications

• Strong research, problem-solving, organizational, and communication skills.
• Ability to manage multiple priorities and coordinate effectively across teams.

Responsibilities

• Coordinate daily activities related to pharmacy benefit operations.
• Support pharmacy programs, projects, and operational initiatives.
• Research and resolve escalated customer service inquiries and grievances.
• Coordinate pharmacy benefit plan administration and quality assurance with internal teams and PBM partners.
• Assist with pharmacy claim adjustments and other benefit-related issues.
• Coordinate coverage determinations, claim reconsiderations, and appeals with clinical teams and appropriate partners.
• Serve as a resource for pharmacy-related processes, issues, and initiatives.
• Escalate complex clinical, contractual, or operational issues as appropriate.
• Assist with RFPs, government program applications, and related requests.

Skills

Research

Problem-solving

Organizational skills

Communication skills

Multitasking

Education

High school diploma or GED

Job description

Beacon Hill is seeking an Intake Specialist to support pharmacy benefit operations in a healthcare environment in Raleigh, NC. You will coordinate pharmacy-related requests, research and resolve escalated issues, and collaborate with PBM partners and internal teams.

The role emphasizes strong communication, research, and organizational skills with multi-tasking ability. Qualified candidates have a high school diploma or GED and 3+ years of related experience, preferably in health insurance, PBM,