Spe-Data-Pharmacy Benefit Management
Current• Demonstrated hands-on experience with the SFDC web application for Case assignment, analyzing benefit requests according to the Client Requirement Document (CRD), and processing them accurately.• Gained practical experience in creating bars, processing claims, and testing claims within the RxClaim application.• Worked on existing plan codes in line with the client's requirements for Cost Saver, WM-Bundle, MyPBM, Drug Coverage, and Accumulation projects.• Ensured timely communication of any issues and provided necessary information to complete case requests.• Developed and managed client-specific implementation plans and processes according to departmental guidelines.• Utilized hands-on experience in running pre-query, plan query, post-query from the Sequel web application system to gather necessary information for implementing plan requests.• Conducted claim testing to ensure accurate claim adjudication.• Engaged in client interactions during weekly huddles for training and issue resolution• Collaborated with multiple teams to complete the Benefit coding with Accuracy & Quality.
