Pharmacy Operations Support Specialist

Lumeris

Full time United States, United States Information and Record Clerks

Posted:

February 21, 2026

Location:

United States, United States, United States

Job Description

Job Description
 :Primary Responsibilities
Reviews rejected pharmacy claims for appropriateness.
Becomes a pharmacy claim processing subject matter expert and triages claims issues.
Assist with resolution of rejected pharmacy claims via provider and/or pharmacy outreach.
Compiles, interprets, documents, and tracks findings from pharmacy claims monitoring data.
Becomes subject expert with Medicare Part D policies and procedures.
Reviews Part D transition claims reports.
Interacts with the pharmacy benefits manager, pharmacies, prescribers, and members to ensure appropriate and timely member access to prescription drugs.
Supports medical pharmacy prior authorizations (Part B).
Supports Medicare Part D Customer Service call center questions and issues received from members, pharmacies, and providers.
Supports compliance functions and requests, including support of the pharma...
                

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Job Overview

Job Type: Full time

Location: United States, United States

Posted: February 21, 2026

Deadline: April 02, 2026