Sr. Pharmacy Resolution Specialist - Complex PA & Claims

Centene Corporation; Town of Texas (WI); Hybrid; USD 26,766 - 45,433; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Job summary

A national healthcare organization in Wisconsin is seeking a Senior Pharmacy Resolution Specialist to handle complex pharmacy issues and serve as a subject matter expert. The role involves taking calls from members and providers, conducting research to resolve claims, and participating in training less experienced staff. The position offers a competitive pay range of $19.43 - $32.98 per hour, along with an extensive benefits package supporting workplace flexibility.

Qualifications

• High School Diploma / GED.
• 2 years of call center / customer service experience.
• Experience in a healthcare environment (pharmacy operations, managed care, pharmacy hospitals, and/or pharmacy retail settings).

Responsibilities

• Acts as a subject matter expert to handle complex pharmacy issues.
• Responds to escalated calls from members, providers, and pharmacies.
• Conducts inbound and outbound calls for resolution to claims.

Job description

A national healthcare organization in Wisconsin is seeking a Senior Pharmacy Resolution Specialist to handle complex pharmacy issues and serve as a subject matter expert. The role involves taking calls from members and providers, conducting research to resolve claims, and participating in training less experienced staff. The position offers a competitive pay range of $19.43 - $32.98 per hour, along with an extensive benefits package supporting workplace flexibility.