Pharma Benefit Analyst Jobs in Hyderabad - Magna Infotech

Responsibilities:

• Analyze benefit requests and secure all necessary data to ensure appropriate. Implementation based on applied logic of RxCLAIM (by SXC) pharmacy claim adjudication system.

• Work with Client Management to implement new and maintain existing benefit plans and client pricing in the pharmacy claim adjudication system.

• Work with Clinical Pharmacy to implement formulary updates and clinical programs in the pharmacy claim adjudication system.

• Work with Pharmacy Network Management to implement pharmacy rate changes and network additions in the pharmacy claim adjudication system.

• Ensure timely communication of any issues and/or information needed to complete a plan request.

• Develop client specific implementation plans and manage implementation processes in accordance with department protocol.

• Run queries out of the RxCLAIM adjudication system to secure all necessary information to implement plan requests.

• Develop and run macros in RxCLAIM to implement plan requests.

• Perform claim testing to ensure accurate claim adjudication.

• Maintain acceptable and appropriate quality levels and production turnaround times

• Adhere to all documentation standards within the department.

• Participate in team meetings.

• Ability to work in a constantly changing environment.

Performance Standard:

• To maintain an accuracy rate - Monthly (DPU: 98.10%; DPMO: 99.90%; IQR: 92.50%)

• Completes assigned projects on time, per TAT defined

Skills:

• Microsoft Office proficiency Word and Excel, specifically Advanced Excel skills -- must have ability to create Excel spreadsheet, macros, compile/analyze data for reporting;

• Excellent analytical skills.

• Good written and verbal skills.

• Detail oriented.

Eligibility:

• Bachelor's Degree in Pharmacy

• Certified pharmacy technician preferred

• Should be Flexible to work in Night Shifts.