Pharmacy Claims Subject Matter Expert - Tulsa Oklahoma

Company: VirtualVocations
Location: Tulsa, Oklahoma
Posted On: 01/29/2025

A company is looking for a Pharmacy Claims Subject Matter Expert (SME).



Key Responsibilities

Provide legal research, guidance, and training to ensure compliance with policies and regulations
Oversee and manage the appeals process for pharmacy claims, ensuring timely resolutions
Develop and maintain reports on appeal outcomes and pharmacy claim trends for leadership decision-making


Required Qualifications and Education

Juris Doctorate from an accredited law school
3-5 years of related professional experience
Experience with pharmacy claims and reimbursements
Experience in prescription drug pricing dispute resolution and/or arbitration
Knowledge of regulatory requirements and industry standards related to pharmacy claims management More...

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