Pharma Benefit Analyst Jobs in Hyderabad - Magna Infotech
Job Description
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Analyze benefit requests and secure all necessary data to ensure appropriate. Implementation based on applied logic of RxCLAIM (by SXC) pharmacy claim adjudication system.
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Work with Client Management to implement new and maintain existing benefit plans and client pricing in the pharmacy claim adjudication system.
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Work with Clinical Pharmacy to implement formulary updates and clinical programs in the pharmacy claim adjudication system.
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Work with Pharmacy Network Management to implement pharmacy rate changes and network additions in the pharmacy claim adjudication system.
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Ensure timely communication of any issues and/or information needed to complete a plan request.
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Develop client-specific implementation plans and manage implementation processes in accordance with department protocol.
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Run queries out of the RxCLAIM adjudication system to secure all necessary information to implement plan requests.
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Develop and run macros in RxCLAIM to implement plan requests.
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Perform claim testing to ensure accurate claim adjudication.
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Maintain acceptable and appropriate quality levels and production turnaround times
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Adhere to all documentation standards within the department.
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Participate in team meetings.
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Ability to work in a constantly changing environment.
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