Pharma Benefit Analyst
- Quess Corp Magna
- 0 Yrs
- Hyderabad
- 3 years ago
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Job Description
Pharma Benefit Analyst(PBA):
Analyze benefit requests and secure all necessary data to ensure appropriate. implementation
based on applied logic of RxCLAIM (by SXC) pharmacy claim adjudication system.
1. Work with Client Management to implement new and maintain existing benefit plans
and client pricing in the pharmacy claim adjudication system.
2. Work with Clinical Pharmacy to implement formulary updates and clinical programs
in the pharmacy claim adjudication system.
3. Work with Pharmacy Network Management to implement pharmacy rate changes
and network additions in the pharmacy claim adjudication system.
4. Ensure timely communication of any issues and/or information needed to complete a
plan request.
5. Develop client specific implementation plans and manage implementation processes
in accordance with department protocol.
6. Run queries out of the RxCLAIM adjudication system to secure all necessary
information to implement plan requests.
7. Develop and run macros in RxCLAIM to implement plan requests.
8. Perform claim testing to ensure accurate claim adjudication.
9. Maintain acceptable and appropriate quality levels and production turn around times
10. Adhere to all documentation standards within the department.
11. Assist with the development of process improvements for the department.
12. Research and respond to all claims processing inquiries from Client
Employement Category:
Employement Type: Full timeIndustry: Pharma / Biotech
Role Category: Pharmacist / Medical Representative
Functional Area: Not Applicable
Role/Responsibilies: Pharma Benefit Analyst
Contact Details:
Company: Quess Corp MagnaLocation(s): Hyderabad
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Quess Corp Magna
Magna Infotech is a division of USD 400 + million Quess Group (quesscorp.com) which in turn is a subsidiary of USD 37+ billion - Canadian Multinational, Fairfax Financial Holding Group. Magna Infotech is the largest staff Augmentation and Solutions Company in India, USA and APAC regions. We are a ...
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