Pharmacy Operations Rep

HCSC; Helena (MT); Hybrid; USD 41,000 - 73,000; Full time

Job summary

Health Care Service Corporation (HCSC) is seeking a Pharmacy Claims Support Specialist to help pharmacists and pharmacy coordinators resolve claims, pricing, and coding issues. You will collaborate with internal teams and external vendors such as PBMs to ensure timely, accurate resolutions and support medication management initiatives.

The role is hybrid (3 days in office, 2 days remote) and requires a bachelor’s degree or equivalent experience, plus certified pharmacy technician credentials and

Qualifications

• Bachelor's degree or four years of work experience in health care/insurance.
• Certified Pharmacy Technician credential.
• Strong verbal and written communication abilities.
• Experience in managed care customer service is preferred.
• Proficiency with word processing, spreadsheets, and databases.

Responsibilities

• Assist pharmacists and pharmacy coordinators with resolving medication claims, pricing, and coding issues.
• Collaborate with internal teams and external vendors (e.g., PBMs) to ensure timely, accurate issue resolution.
• Manage inbound calls and perform member/provider outreach related to pharmacy matters.
• Support population health initiatives and participate in data-driven projects to improve operations.

Skills

Verbal and written communication

Managed care customer service

Drug information skills

Multitasking and organization

Education

Bachelor's degree in Business or related health care field

Certified Pharmacy Technician

Job description

Flex

IL - Chicago

MT - Helena

NM - Albuquerque

TX - Richardson

R0056276

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

This position is responsible for providing assistance to pharmacists and pharmacy coordinators in resolution of claims, pricing, coding. Works with internal departments and external vendors to evaluate and resolve pharmacy related issues.

Job Description:

The position supports pharmacists and pharmacy coordinators in resolving medication claims and inquiries, working with internal teams and external vendors (e.g., PBMs) to ensure timely and accurate issue resolution. This role manages inbound calls, conducts member and provider outreach, and collaborates with pharmacists on account-based work to support medication management. Additionally, the position supports population health initiatives and participates in project-based, data-driven efforts to improve operational outcomes.

Job Requirements:

• Bachelors degree in Business or a related health care field or four years work experience in a health care/insurance industry (or equivalent)


• Certified Pharmacy Technician


• Verbal and written communication skills


• Managed care customer service experience


• Demonstrated proficiency of word processing spreadsheets and database software


• Drug information skills


• Handle multiple tasks and strong organizational skills

This is a Flex (Hybrid) role: requires 3 days in office; 2 days remote

#LI-AC1

#LI-Hybrid

Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards .

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

Flex employees are expected to be in the office a minimum of three days a week. Management will have discretion to modify an employee's weekly schedule for exigent circumstances.

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.

Base Pay Range

$40,500.00 - $72,500.00

Exact compensation may vary based on skills, experience, and location.

For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities.

Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment.

HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants.

If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations.

Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC’s Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions.

Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas,

Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association

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