Pharmacy Support Specialist
La Grange, KY 
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Posted 12 days ago
Job Description
The Rawlings Group, founded in 1977, is the premier leader in payment integrity services to the health insurance industry.  Located in La Grange, KY, The Rawlings Group employs over 1,400 people and is growing.  If you are looking for a great opportunity to make a positive impact on the future of healthcare, The Rawlings Group needs to be your career choice.
 
JOB SUMMARY  
The Pharmacy Support Specialist is responsible for performing various client on-line look-ups and validation procedures that support the production and distribution of client audits in the Pharmacy Division.  The role involves organizing, storing and processing both digital and paper information.  The person selected must be comfortable using digital hardware and software, so they can total figures in spreadsheets, write letters using word-processing applications and respond to emails. They must also be able to use common office machines, including copiers, fax machines, scanners, and phone systems. 
 
 
 
ESSENTIAL DUTIES & RESPONSIBILITIES  
  • Validate COB information and claims processing information to support ongoing investigations or recoveries in client systems.
  • Utilize client systems to validate eligibility information for members on the Post-Term file from the client.
  • Process inbound retro-termination response mail received to the Pharmacy P.O. Box for bad address handling, logging, and escalating all complaints and dispute letters to Pharmacy Management in a timely manner.
  • Assist with the administration of the Pharmacy Post-Term program by processing direct payments, managing inbound mail responses and perform other necessary data entry functions on a monthly basis.
    • Perform special projects and provide administrative assistance to Pharmacy Leadership.
  • Manage all letter templates for the Pharmacy Division.
    • Manage the Pharmacy SharePoint site.
    • Post checks for all Pharmacy departments as needed and scan remit explanation of benefits or other correspondence to proper folders in SharePoint.
    • Must possess knowledge of computer hardware and software, including applications and programming that is used to pull information for data needed in the Pharmacy Division.
    • Assist in the updates and improvements of Client On-line Access documentation.
 
OTHER DUTIES & RESPONSIBILITIES  
  • General Administration- special projects and provide administrative assistance to the Pharmacy Leadership Team
  • Performs other duties as assigned.
 
SKILLS & ABILITIES  
  • Experience with Excel required. 
  • Analytical mindset.
  • Able to handle multiple priorities.
  • Ability to learn and adapt to new concepts quickly.
  • Excellent attention to detail and organizational skills.
  • Demonstrates professionalism in all dealings with peers and management. 
  • A proven high level of energy and productivity in supporting a team effort to achieve production goals.
  • Accomplished verbal communication skills, use correct grammar and displays an enthusiastic customer service attitude.
  • Ability to think outside of the box.
 
EXPERIENCE REQUIREMENTS  
  • Experience using Excel and web-based applications
  • A proven record of being dependable and reliable, someone who is effective, even in changing circumstances.
  • Familiarity with health insurance a plus.
 
EDUCATION REQUIREMENTS  
  • Bachelor’s Degree preferred.

Equal Opportunity Employer
Veteran Friendly Employer

 

Job Summary
Start Date
immediately
Employment Term and Type
Regular, Full Time
Hours per Week
40
Work Hours (i.e. shift)
8:00 - 5:00
Salary and Benefits
$16.00 - $17.50/hour
Required Education
Some College
Required Experience
2+ years
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