Accerta
Accerta Drug Claims Expert Position
Job Description
Join Accerta as a Drug Program Specialist to leverage your knowledge in drug benefit administration. This full-time, hybrid role focuses on claims adjudication and regulatory compliance.
You will lead initiatives in adjudication processes, regulatory adherence, and data ingestion, while working closely with the Product Director and technical teams. Your role is pivotal in shaping how drug claims are managed, ensuring accurate implementation of benefit rules and collaboration with external partners.
Key Responsibilities:
• Define adjudication logic, including formulary updates
• Create and execute UAT for drug benefit workflows
• Collaborate with stakeholders to validate configurations
• Drive issue resolution and risk mitigation strategies
• Maintain comprehensive documentation on performance
Requirements:
• Minimum 8 years in drug claims or benefits administration
• Familiarity with pharmaceutical terminology and workflows
• Experience in agile environ...
You will lead initiatives in adjudication processes, regulatory adherence, and data ingestion, while working closely with the Product Director and technical teams. Your role is pivotal in shaping how drug claims are managed, ensuring accurate implementation of benefit rules and collaboration with external partners.
Key Responsibilities:
• Define adjudication logic, including formulary updates
• Create and execute UAT for drug benefit workflows
• Collaborate with stakeholders to validate configurations
• Drive issue resolution and risk mitigation strategies
• Maintain comprehensive documentation on performance
Requirements:
• Minimum 8 years in drug claims or benefits administration
• Familiarity with pharmaceutical terminology and workflows
• Experience in agile environ...