Clinical Care Representative

Job Summary

A company is looking for a Clinical Care Representative responsible for managing clinical tasks related to communications with clients, members, pharmacies, and physicians.

Key Responsibilities

• Handle account inquiries and claims processing, including prior authorization requests and troubleshooting claim issues
• Support consulting services by analyzing Rx data and assisting members with cost-effective medication alternatives
• Perform administrative tasks such as logging claims, preparing invoices, and updating documents on SharePoint

Required Qualifications

• Associate degree in a related field preferred, but not required
• Active pharmacy technician license preferred, but not required
• Two years of applicable experience preferred
• Knowledge of claims processing is helpful
• Strong computer skills, particularly in Microsoft Office applications