Remote Pharmacy Benefits Specialist

ExactCare Pharmacy

Northern (KY)

Remote

USD 42,000 - 66,000

Full time

5 days ago

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Benefits offered by this job

Medical/dental/vision

Flexible spending

Company-paid life insurance

Short-term disability

401(k)

Paid time off

Paid holidays

Job summary

AnewHealth is a leading pharmacy care management company delivering comprehensive services nationwide. This remote role handles client inquiries, educates on plan benefits, and processes prior authorizations while maintaining HIPAA compliance.

The specialist will collaborate with pharmacies, plan sponsors, and internal teams to resolve complex benefit issues. The ideal candidate has at least 3 years in customer service, 2+ years in healthcare and pharmacy support, and strong knowledge of plan

Qualifications

Required: Associate’s degree or equivalent combination of education or work experience.
Preferred: CPhT certification.

Responsibilities

Answer telephone inquiries in a pleasant, professional manner.
Document calls and dialogue in the claims adjudication software.
Educate clients on plan policies, benefits, and procedures.
Resolve client drug benefit concerns of medical, financial, or technical nature.
Initiate and facilitate prior authorization requests.
Submit JIRA tickets for prescriptions and NDC issues.
Stay current on plan structures, pharmacology updates, and Medicare Part D guidelines.