As A Pharmacy Insurance Specialist, You Will Be Responsible For Ensuring That All Required Liability Insurance Labels Are Entered And Properly Maintained Within The Pharmacy's Filing System. A Pharmacy Benefits Specialist Will Conduct Extensive Testing And Documentation To Ensure Accurate Prescription Claims Processing While Adhering To Clinical Standards And Payer Requirements. As A Member Of The Network Operations Team, This Role Allows You To Review Other Programs and analyze And Resolve Issues Related To The Organization Of Prescriptions With Stores, Providers, Patients, Pricing, And Financial Impact On The Company.

 Other Duties Of A Medical Insurance Specialist Include:

• -Receive Contract Updates From Other Programs And Create Or Modify Third-Party Plans As Necessary To Comply With Company Standards, Contract Agreements, And State And Federal Regulations.
• Works With The Pharmaceutical Application Development Team And Information Systems (IS) To Provide Prescription Request Processing Support For Any System-Related Issues Or Improvements, Including Defining Business Conditions And System Testing, Analyzing Production Issues For Any Possible Cause, And To Reproduce Any Known Defects. Test Environment To Help Development
• Worked Within The Department To Ensure The Reliability Of The Pharmacy Services By Performing Various Conditions That Affect The Quality Of Data, Processing Prescription Requests, And Providing In-Depth Analysis Of Results.
• This Job Is Considered "Hybrid" And The Co-Worker Is Expected To Be Available On Tuesday, Wednesday, And Thursday Of The Work Week.

Qualifications Required

• 1+ Years Of Related Experience In Pharmacy, PBM Or Insurance
• 1+ Years Of Experience Using Microsoft Word And Excel

Eligibility Of Candidates

• 3+ Years Of Related Experience In Pharmacy, PBM Or Insurance
• Previous Experience In Industry, Department Or Customer Relations
• Experience Working In A High Volume Environment (I.E., Pharmacy Technician, Medical Billing)
• Experience With SQL Or Access
• Experience In Creating Effective Presentations

Job Benefits:

• Health Benefits: Because Aetna Is A Health Insurance Company, It Generally Offers Comprehensive Health Benefits, Including Health, Dental, And Vision Insurance, To Eligible Employees And Dependents.
• Wellness Programs: Aetna Promotes Employee Wellness Through A Variety Of Programs, Which May Include Exercise Groups, Health Challenges, And Resources To Maintain A Healthy Lifestyle.
• 401(K) Retirement Plan: Aetna May Offer A 401(K) Plan That Allows Employees To Save For Retirement Through Tax-Deductible Contributions. Some Companies Also Offer Matching Offers.
• Time Off (PTO): This Can Include Vacation Days, Sick Days, And Statutory Holidays, Allowing Employees To Take Time Off Work While Still Being Paid.
• Flexible Spending Accounts (FSA): These Accounts Allow Employees To Withdraw Pre-Tax Dollars To Cover Medical, Dental And Dependent Care Expenses.
• Life Insurance And Disability Insurance: Aetna Can Provide Life Insurance And Disability Insurance To Help Protect Employees And Their Families Financially.
• Employee Assistance Programs (Eaps): Eaps Provide Support For Personal And Employment Issues, Including Counseling, Legal Assistance, And Financial Planning.
• Professional Development: Aetna Can Provide Professional Development Opportunities Through Training, Courses, And Educational Resources.
• Parental Leave: Maternity And Paternity Leave To Support Employees When They Become Parents.
• Tuition Assistance: Some Companies, Including Aetna, Offer Tuition Reimbursement Or Assistance Programs To Help Employees Continue Their Education.
• Employee Discounts: Discounts On Aetna Health Insurance Plans And Other Potential Products And Services.
• Remote And Flexible Work: Depending On The Service, Aetna May Offer Flexible Work Arrangements Or Remote Work Options.