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Pharmacy Insurance Specialist

Woonsocket, RI

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RemX is hiring a Pharmacy Insurance Specialist in Woonsocket, RI.

Pay rate: $20 per hour 

Schedule: Monday-Friday 8 am to 5 pm

Onsite: Woonsocket, RI 02895 

Contract position

Job Responsibilities:

  • Ensure that all required third party insurance settings are coded and maintained appropriately within the pharmacy adjudication system
  • Perform extensive testing and documentation to ensure accurate prescription claims processing while remaining in compliance with pharmacy standards and payer requirements
  • Analyze third party programs and investigate and resolve systemic issues relative to prescription claims processing that interface with stores, providers, patients, pricing, and financial impacts to the company
  • Receive third party program contract updates and creating or modifying third party plan configurations necessary to comply with industry standards, contract agreements and state and federal regulations
  • Working with Pharmacy Application Development teams in Information Systems (IS) to provide prescription claims processing support for all system related issues or enhancements including defining business scenarios and testing procedures, analyzing production issues for any potential causes and recreating all known defects in test environments to assist development
  • Working cross-functionally within the department to provide quality assurance within Pharmacy Operations by executing various scenarios affecting data quality, prescription claim processing and providing in-depth analysis of the results

Job Requirements


  • 1+ year related experience in a pharmacy, PBM, or insurance position
  • 1+ years of experience using Microsoft Word and Excel
  • Preferred: Pharmacy Technician Experience
  • Preferred: Previous experience with business-to-business, interdepartmental, or customer interactions
  • Preferred: Retail Pharmacy help desk experience
  • Preferred: Experience with SQL or Access
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