Insurance Pharmacist
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Key skills for this role
About the Role
My Clinic KSA is seeking an Insurance Pharmacist to support pharmacists with insurance queries, follow up on pre-authorization requests, and communicate with insurance companies. Candidates need a Bachelor's in Pharmacy and at least two years of experience in the same field.
Key Skills for This Role
Responsibilities
- Work as a back line support with pharmacists to help them with insurance queries
- Follow up rejected pre authorization requests and process to get approval if covered by CHI policy and medically justified
- Communicate directly with insurance companies’ doctors and delegates to gain approval for medications
- Manage and handle missed pre authorization requests
- Keep updated with new insurance companies policies and medical guidelines
- Work with patients to help them understand their insurance coverage
- Update list of not covered medications according to CHI new rules and insurance companies’ policies
- Update drug formulary classification according to updated IDF of SFDA drug list
- Train front line pharmacists and keep them updated about insurance details
- Make data analysis for rejected medications to avoid rejection reasons in future claims
Requirements
- Bachelor degree in pharmaceutical science
- Minimum of two years’ experience in the same field
- Insurance foundation certificate
Full Job Posting
Job Description
- Work as a back line support with pharmacists to help them if they have any insurance queries
- Follow up the rejected pre authorization requests and process on it to get approval if the request is covered by CHI policy and medically justified
- Communicate directly with insurance companies’ doctors and delegates to gain approval for medications
- Managing and handling the missed pre authorization requests
- Keep updated with the new insurance companies policies and medical guidelines to apply the exceptions or additional rules in each
- Work with patients to help them understand their insurance coverage and answer any related queries they might have
- Update the list of not covered medications according to CHI new rules and insurance companies’ different policies
- Update the drug formulary classification according to updated IDF of SFDA drug list to correctly implement the new deductible policy of CHI
- Train front line pharmacists and keep them updated about insurance details
- Make data analysis for the rejected medications to avoid the rejection reasons in the future claims
- Perform other professional duties requested from line manager
Education / Professional Qualifications
- Education Degree: Bachelor degree in pharmaceutical science
- Years of Experience: minimum of two years’ experience in the same field
- Certificate: Insurance foundation certificate
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