Rx Claims SME

TechDigital
  • Eden Prairie, MN
    30+ days ago

    Job Description

    JD:
    1. In depth knowledge on RxClaim Adjudication, claims processing, MedD claims
    2. Deep knowledge of PBM concepts, including drug pricing, copays, accumulators, and Drug Utilization Review (DUR)
    3. Knowledge on business & plan configuration and plan option knowledge.
    4. Facilitate discussion with Product Owners, Business and clarify business requirements
    5. High level knowledge in executing root cause analysis, managing data validation, and navigating automated database systems/reporting tools.

    Numbers & Facts

    LocationEden Prairie, MN
    IndustryOther/Not Classified
    Company Size100 to 499 employees

    Skills

    • Business Planunmatched
    • Co-Paymentsunmatched
    • Data Managementunmatched
    • Data Qualityunmatched
    • Database Report Toolsunmatched
    • Database Technologyunmatched
    • Pricingunmatched
    • Root Cause Analysisunmatched
    • Utilization Managementunmatched

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