Benefits Technician I
Pharmpix Guaynabo, PR
- Posted: over a month ago
This is your chance to unleash your full potential!
PharmPix, is currently seeking for qualified Benefits Technician I candidate to join our team. We are looking for successful people like you. Join the fastest growing Pharmacy Benefit Management (PBM) company in its category and take your professional career to the next level. PharmPix has become a leading provider of pharmacy benefit solutions and services in the continental United States and the territories.
Our work philosophy is based on commitment, dedication and loyalty. We take care of our employees, just as we ensure the welfare of our clients and partners. If you are creative, service oriented, resourceful and visionary, we would like to hear from you.
The Benefits Technician I report to the Benefits and Implementations Supervisor and is responsible for standard system coding, maintenance, and quality assurance in the internal system, including building out standard plan designs, rates, clinical programs, and pharmacy networks. Additionally, this role serves as the important first line of contact for our clients, providing them accurate information to help resolve any issues and/or concerns. They are essentially the subject matter expert for all matters related to PharmPix clients and vendors
Essential Roles and Responsibilities
- Analyze standard and customized coding requests and work with internal teams to obtain the accurate and complete plan documentation needed to code client intent into the internal system.
- Implement new and maintain existing benefit plans, rates, and networks in the system, consistent with the direction and intent set forth by the client and PharmPix.
- Work collaboratively with the Quality Specialist to perform pre- and post-implementation claim testing and other configuration quality reviews to ensure accurate claim adjudication and adherence to standard and custom design requirements.
- Identify discrepancies, inaccuracies and unintended consequences, and take corrective action.
- Research and respond to claims processing and system configuration inquiries from internal departments.
- Proactively identify setup service issues and escalate to the Benefits and Implementations Supervisor or Manager for immediate review and resolution.
Professional Experience and Skills Requirements:
- Pharmacy Technician Associate Degree or equivalent professional experience.
- One (1) year or more of experience in a PBM/Health Plan Environment or; Retail Pharmacy or proven experience as a data analyst.
- Puerto Rico Board of Pharmacy Technician Certification, preferred.
- Proficiency in the use of Microsoft Tools: Excel, Word, Outlook, Office 365 and Power Point.
- Knowledge of Federal and The Commonwealth of Puerto Rico health care delivery and pharmacy regulations / regulatory agencies, preferred.
- Must be able to type a minimum of 35wpm and have the ability to multi-task moving from multiple screens on dual monitors
- Fully bilingual: Spanish and English.
- Excellent time management and organizational ability.
- Ability to multitask and meet constant deadlines.
The candidate must have:
- 100% of the Covid-19 Vaccine.
- Internet Accessibility with or more 10MB speed.
- Must be able to work hybrid (on site and remote)
PharmPix is an Equal Employment Opportunity Employer Minorities / Females / Disable / Veterans
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