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CareOregon, Inc.

Remote Pharmacy Benefits Specialist II (PBM Expert)

northern, KY

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Job description

CareOregon, Inc. is hiring a Pharmacy Benefit Specialist II to support members, providers, and pharmacies with the pharmacy benefit under the major medical plan.

Responsibilities include customer service, claims processing, prior authorizations, formulary exceptions, and appeals. The role involves data entry, project participation, and coordination of PA and formulary decisions, with a focus on HIPAA-compliant service and professional communication.

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