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Rx Claims SME W2 Only
Job Location:
Job Location:
Eden Prairie, MN - USA
Monthly Salary:
Not provided by the employer
Monthly Salary:
Posted:
10 June 2026 (30+ days ago)
Posted:
Application Deadline:
7 September 2026
Application Deadline:
Vacancies:
1 Vacancy
Vacancies:
Job Summary
Role: Rx Claims SME
Location: Eden Prairie - MN; hybrid
W2 Position
| Name | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Benefit Administration-PBM | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Pharmacy Claims | |
JD:
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.
Years of Experience: 10.00 Years of Experience
