**NO EXPERIENCE NECESSARY- WE WILL TRAIN**Do you want a career where you can make a difference? Allegiance is a growing company that is looking for dynamic candidates to join the team! A positive, team-oriented environment is provided with opportunities for advancement.Allegiance offers full-time positions with evenings, weekends, and holidays off and a multi-faceted benefits package.We pride ourselves in having a reputation for top-notch customer service. Make a difference. Start your career with Allegiance today!REPORTS TO: Pharmacy Service Team SupervisorLOCATION: Allegiance Office or Off-siteFLSA STATUS: Non-ExemptPOSITION RESPONSIBILITIES:The PBM Implementation Coordinator is responsible for the coordination of the implementation for group's benefits with a current or new Pharmacy Benefit Manager (PBM). This includes all support functions necessary to provide accurate information with courteous and timely service to all clients and plan participants. Occasional travel maybe required.ESSENTIAL JOB FUNCTIONS:Essential job functions include the following. Other functions may be assigned as business conditions change. * Coordinates and schedules meetings with vendors/brokers/ clients as needed for PBM implementations.
Assists with reviews and gets approval on ID card approvals from the PBM.
Assist with submitting EDI tickets timely and accurately.
Attends new group meetings to obtain all information available regarding current pharmacy
Maintains meeting notes via OneNote for all new groups and PBM implementations.
Assist with updating/maintaining internal PBM implementation checklist/spreadsheet.
Assist with getting documentations for compliance/SPD. Obtains clarity on any SPD questions for the compliance department.
Assist with getting requests SFTP sites as needed and ensures automation is set up with IT for incoming eligibility reports and claims files.
Assist with suppling internal teams with the information needed for the HCI portal.
Maintain/updates the PBM contact Spreadsheet for the department.
Contributes to the daily workflow with regular and punctual
Answers telephone calls, emails, and faxes from PBMs, plan sponsors, plan participants, providers, and internal departments pertaining to pharmacy benefits, claims inquiries; eligibility and programming; provides prompt, clear and accurate responses to requests for information
Meets personally with clients as necessary to assist them with questions pertaining to their pharmacy
Assists Marketing Department with PBM questions as needed.
NON-ESSENTIAL JOB FUNCTIONS: * Performs related or other assigned duties as required or directed.SUPERVISION EXERCISED:None.PHYSICAL WORKING CONDITIONS:Physical requirements are representative of those that must be met to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Sitting80%ReachingSomeStanding10%Manual DexterityHighWalking10%TelephoneYesKneelingSomeComputer ScreenHigh (visual acuity corrected to 20/30)BendingSomeLiftingup to 30 poundsJOB SPECIFICATIONS:To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Minimum Education: High school graduation or GED required. College degree and/or training in medical terminology preferred.Certification(s) Required: NoneMinimum Experience: Previous experience with computer software applications is required. Work experience with group health benefits or in the health insurance industry preferred.Other Qualifications:
Excellent oral and written communication skills required.
PC skills, including Windows, Excel, Access, Word, internet navigation, and email applications. PowerPoint preferred. Ability to learn all functions of the claims processing software as is necessary for data entry, research and report generation. Must be able to adapt to software changes as they
Accurate data entry and typing
Knowledge of medical terminology and basic health insurance
Excellent listening
Basic mathematical
Ability to gain thorough knowledge of pharmacy benefit systems and
High level of interpersonal skills to work effectively with
Ability to organize and recall large amounts of detailed
Ability to project a professional image and positive attitude in any work
Ability to comply with privacy and confidentiality
Ability to be flexible, work under pressure and meet
Ability to analyze and solve problems with professionalism and patience, and to exercise good judgment when making decisions.
Ability to take initiative and work independently.
Ability to operate typical office
Working knowledge of general office procedures.
The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel as classified.*Allegiance Benefit Plan Management, INC is an Equal Opportunity Employer. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.If you require reasonable accommodation in completing the online application process, please email: for support.Job Posted by ApplicantPro
