Rx Claims Engineer

Job Description:

1. In depth knowledge on RxClaim Adjudication, claims processing, MedD claims

2. Deep knowledge of PBM concepts, including drug pricing, copays, accumulators, and Drug Utilization Review (DUR)

3. Knowledge on business & plan configuration and plan option knowledge.

4. Facilitate discussion with Product Owners, Business and clarify business requirements

5. High level knowledge in executing root cause analysis, managing data validation, and navigating automated database systems/reporting tools.