Pharmacy Benefits/Insurance Claims Specialist | Onsite- Boise

Legal & ComplianceClaims Specialist

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Requirements Summary

High school diploma or GED required, Bachelor’s degree strongly preferred One year of Pharmacy Experience,

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Legal & ComplianceClaims Specialist

~2 min read

✓Medical, dental, and vision coverage starting day 1

✓401k with Traditional and Roth options

✓Paid sick and vacation time

✓Holidays off

✓12 weeks of paid parental leave for birthing parents; 4 weeks for non-birthing parents (including adoption and foster placement)

✓Short-term and long-term disability coverage at no cost

✓Life insurance

✓Commuter FSA for pre-tax transit and parking savings; free onsite parking at all pharmacy locations

✓Employee Assistance Program (EAP) with counseling, life and wellness coaching, legal/financial advice, and more

✓Daily snack and drink stipend at all pharmacy locations

~1 min read

→Process pharmacy claims accurately and timely to meet client expectations
→Triage rejected pharmacy insurance claims to ascertain patient pharmacy benefits coverage
→Maintain compliance with patient assistance program guidelines
→Document all information and data discovery according to operating procedures
→Research required information using available resources
→Maintain confidentiality of patient and proprietary information
→Perform all tasks in a safe and compliant manner that is consistent with corporate policies as well as State and Federal laws
→Work collaboratively and cross-functionally between management, the Missouri-based pharmacy, compliance and engineering

~1 min read

High school diploma or GED required, Bachelor’s degree strongly preferred
One year of Pharmacy Experience, having resolved third party claims
Healthcare industry experience with claims background
Strong verbal and written communication skills
Attention to detail and a strong operational focus
A passion for providing top-notch patient care
Ability to work with peers in a team effort and cross-functionally
Strong technical aptitude and ability to learn complex new software
Must hold an active Pharmacy Technician license OR Pharmacy Technician in Training License in the state of Idaho, registered with the Idaho Board of Pharmacy

Hours/Location:
- Shift: 3 available Shift Options
  - Rotating shifts, 40 hours/week between 8 AM - 7 PM MST, Monday - Friday OR
  - 10 AM - 6 PM MST, Monday - Friday (Fixed Shift) OR
  - 11 AM - 7 PM MST, Monday - Friday (Fixed Shift)
  - All shifts require 1 Saturday shift, every 4 weeks of 7 AM - 3 PM MST
- Mandatory Training first 6 - 8 weeks from 8 AM- 4 PM MST
Onsite full time position located at 12639 W Explorer Dr #100, Boise, ID 83713