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| Job Location | Hyderabad |
| Education | Not Mentioned |
| Salary | Rs 2.0 - 2.5 Lakh/Yr |
| Industry | Pharma / Biotech |
| Functional Area | Pharmacist / Medical Representative |
| EmploymentType | Full-time |
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
Keyskills :
pharmacy benefit managementhealth claimspharmacyhealth care