Job Description – Pharmacy Associate

Job Title

Pharmacy Associate

Job Summary

The Pharmacy Associate is responsible for supporting pharmacy-related operations by reviewing medication claims, processing pre-authorizations, verifying formulary coverage, and coordinating with pharmacies, healthcare providers, and policyholders. The role ensures accurate and timely processing of pharmaceutical services while maintaining compliance with company policies and regulatory requirements.

Key Responsibilities

• Review pharmacy insurance claims for accuracy, completeness, and policy compliance.
• Process medication pre-authorizations and obtain required approvals.
• Verify prescriptions against insurance benefits, exclusions, and formulary coverage.
• Coordinate with pharmacies, hospitals, physicians, and members regarding medication-related inquiries.
• Resolve pharmacy claim rejections, discrepancies,...