Walgreens Third Party Specialist Rx Operations Pharmacy Technical Services in DEERFIELD, Illinois
Responsible for the update, maintenance, auditing, and operation of third party prescription plan contracts, including entering plans into the system, investigating all missing information, and issues resolution from the stores.
Responsible for the update, maintenance, auditing, and operation of third party prescription plan contracts, including entering plans into the system and investigating all missing information.
Responsible for resolving problems and questions regarding third party prescription plans from stores, claims processors, and other applicable parties. Identifies and recommends best practices solutions to recurring issues.
Enters plan specifications into the appropriate systems, ensuring compliance with plan provisions, corporate guidelines, and Federal, state, and/or local regulations.
Develops and test data for each new plan and conducts on-line tests to ensure appropriate claims processing and reimbursement. Identifies and implements corrective actions for test results that are not compliant with the plan specifications.
Collaborates with third party payor and appropriate Walgreens team members to ensure operational performance and compliance with the responsible third party contractor.
Analyzes and recommends corrective actions to systems discrepancies, prescription and reimbursement data, vendor changes, claims processors, etc.
Assists other Walgreens departments with audits, both fiscal and operational, to ensure all appropriate data is made available to accurately complete internal and external plan audits.
May respond to federal and state issued subpoenas and coordinate access to internal corporate applications. May also perform various administrative functions, when necessary, such as scheduling meetings, coordinating group events etc).
An Equal Opportunity Employer, including disability/veterans
Walgreens (www.walgreens.com) is included in the Retail Pharmacy USA Division of Walgreens Boots Alliance, Inc. (Nasdaq: WBA), a global leader in retail and wholesale pharmacy. As America’s most loved pharmacy, health and beauty company, Walgreens purpose is to champion the health and wellbeing of every community in America. Operating more than 9,000 retail locations across America, Puerto Rico and the U.S. Virgin Islands, Walgreens is proud to be a neighborhood health destination serving approximately 8 million customers each day. Walgreens pharmacists play a critical role in the U.S. healthcare system by providing a wide range of pharmacy and healthcare services. To best meet the needs of customers and patients, Walgreens offers a true omnichannel experience, with platforms bringing together physical and digital, supported by the latest technology to deliver high-quality products and services in local communities nationwide.
Job ID: 604476BR
Title: Third Party Specialist Rx Operations Pharmacy Technical Services
Company Indicator: Walgreens
Job Function: Health Care-Pharmacy
Full Store Address: 200 WILMOT RD,DEERFIELD,IL 60015
Full District Office Address: 200 WILMOT RD,DEERFIELD,IL,60015-04620-00001-2
External Basic Qualifications:
High School Diploma/GED and at least 2 years of experience in retail pharmacy, medical claims processing, and/or third party reimbursement.
Required certification in Certified Pharmacy Technician as granted by PTCB.
Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction.
Experience with project management (for example: planning, organizing, and managing resources to bring about the successful completion of specific project goals and objectives).
Basic level skill in Microsoft Office 2003 or later: Word (for example: creating documents, entering and formatting text, page layouts, creating tables, and adding graphics), Excel (for example: creating worksheets, entering data, creating basic formulas, working with cells and rows) and PowerPoint (for example: creating a new presentation from a design template, adding and removing slides, entering and formatting text, adding speaker notes, and viewing presentations).
- At least 2 years experience in pharmacy claims processing.
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