Benefits Coordinator (Pharmacy)

$54,080 - $54,080/Yr

Johnson Service Group - Irvine, CA

Full-time

Remote - Irvine, CA

Administrative and Support Services

About the position

The Benefits Coordinator (Pharmacy) role at Johnson Service Group involves providing exceptional customer service and operational support within the pharmacy benefits management sector. This position is responsible for addressing member inquiries, assisting with prior authorization requests, and supporting the development of policies and procedures to enhance service delivery. The coordinator will also contribute to operational reporting and workflow improvements, ensuring compliance and maximizing revenue for contracted business arrangements.

Responsibilities

• Respond to member questions regarding prescription drug benefits via telephone, e-mail, and written correspondence.
• Assist Benefits Coordinator II with coordinating intake and processing of Prior Authorization Requests.
• Support training of Customer Service Representatives (CSRs) to handle inquiries effectively.
• Help develop policies and procedures for customer service agents.
• Resolve escalations in a timely manner to meet Service Level Agreements.
• Manage the PBM customer service Help Desk for day-to-day tasks including call tracking and customer service emails.
• Assist in developing client-facing reporting and communications.
• Implement PBM client management activities to achieve revenue and compliance goals.
• Achieve service level targets in pharmacy operations.
• Research new business opportunities and contribute to workflow improvements.
• Deliver operational reporting products including critical metric reporting and performance dashboards.
• Back-up Pharmacy Benefit Analyst II in process improvements and quality assurance activities.

Requirements

• High school education or equivalent.
• 1-3 years of experience in Pharmacy Benefit Management or related fields.
• Pharmacy Technician Certification Board National Certification (PTCB).
• Intermediate knowledge of prescription benefits and pharmacy claims.
• Patient care oriented with ability to prioritize tasks.
• Intermediate knowledge of Microsoft Office Suite, especially Excel.
• Excellent written and oral communication skills.
• Good project-based task skills.
• Basic ability to use advanced Excel features like pivot tables and v-lookups.
• Intermediate ability to research and analyze issues.
• Demonstrated ability to communicate complex concepts to senior leadership.
• Strong analytical thinking and problem-solving skills.
• Availability to work weekends and evenings.