6 months contract to hire | Pittsburgh, PA | Boise, ID
Oxford Solutions has an opening for a Pharmacy Benefits Specialist to join our client’s growing team. In this role, you will process pharmacy claims, research insurance coverage, and collaborate with internal teams to ensure patients receive timely and accurate support.
Responsibilities
Accurately process pharmacy claims in compliance with program guidelines and client expectations
Review and resolve rejected claims, researching patient pharmacy benefit coverage and eligibility
Maintain compliance with patient assistance program requirements and all State and Federal regulations
Research and document claim and benefit issues using available systems and resources
Communicate effectively with patients, providers, and internal teams to resolve issues
Protect the confidentiality of all patient and proprietary information
Partner with management, compliance, and the pharmacy team to improve accuracy and workflow efficiency
Requirements
High school diploma or GED required; Bachelor’s degree preferred
At least 1 year of pharmacy experience, including third-party claims resolution
Strong working knowledge of pharmacy benefit coordination, copay assistance programs, and insurance plan structures
Understanding of Medicare Parts A, B, and D, Medicare Advantage plans, and coordination of benefits processes
Excellent communication skills and attention to detail
Ability to work independently and as part of a team in a fast-paced environment
Schedule & Location
Full-time, onsite roles available in Pittsburgh, PA (Robinson) or Boise, ID
Shifts vary between 8 AM and 9 PM EST, Monday through Friday, with occasional rotating Saturday shifts (9 AM – 5 PM).
Flexibility is required, as schedules may change based on business needs.