Analyze benefit requests and secure all necessary data to ensure appropriate implementation based on applied logic of RxCLAIM (by SXC) pharmacy claim adjudication system.
Work with Client Management to implement new and maintain existing benefit plans and client pricing in the pharmacy claim adjudication system.
Work with Clinical Pharmacy to implement formulary updates and clinical programs in the pharmacy claim adjudication system.
Work with Pharmacy Network Management to implement pharmacy rate changes and network additions in the pharmacy claim adjudication system.
Ensure timely communication of any issues and/or information needed to complete a plan request.
Develop client specific implementation plans and manage implementation processes in accordance with department protocol.
Run queries out of the RxCLAIM adjudication system to secure all necessary information to implement plan requests.
Develop and run macros in RxCLAIM to implement plan requests.
Perform claim testing to ensure accurate claim adjudication.
Perform claim testing to ensure accurate claim adjudication.
Maintain acceptable and appropriate quality levels and production turn around times
Adhere to all documentation standards within the department.
Assist with the development of process improvements for the department.
Research and respond to all claims processing inquiries from Client
Interested Candidates can walkin for an interview from 11 May 2016 to 13th May 2016 anytime between 10am to 2pm on the below mentioned address:
A2 Square, First floor, Plot #8,
Ayyappa Society Main Road,
Jaihind Enclave,
Landmark : Near YSR statue (100 feet road),
Madhapur, Hyderabad - 500016
Contact Person- Apoorva
Ayyappa Society Main Road,
Jaihind Enclave,
Landmark : Near YSR statue (100 feet road),
Madhapur, Hyderabad - 500016
Contact Person- Apoorva
Recruiter - Jyoti Pundhir
Desired Candidate Profile
Education-
- Please refer to the Job description above
Company Profile:
Recruiter Name:Mr. Farhad Wadia
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