Opportunity Description
Job Title: Rx Claims SME
Location: Eden Prairie, MN (Hybrid)
Duration: 6+ Months
About the Rol
eIn depth knowledge on RxClaim Adjudication, claims processing, MedD claims
.Responsibilitie
- sDeep knowledge of PBM concepts, including drug pricing, copays, accumulators, and Drug Utilization Review (DUR)
- .Knowledge on business & plan configuration and plan option knowledge
- .Facilitate discussion with Product Owners, Business and clarify business requirements
- .High level knowledge in executing root cause analysis, managing data validation, and navigating automated database systems/reporting tools