About the Company
Cone Health is a not-for-profit healthcare network serving people in Guilford, Forsyth, Rockingham, Alamance, Randolph, and Caswell counties. Our brand promise – We are here for good. ® – is an unwavering commitment to excellence, service and the well-being of our community. Join our team and contribute to a healthier community.
Job Description
We are seeking a highly organized and detail-oriented Pharmacy Benefits Coordinator to join our Human Resources and Insurance Administration team. In this pivotal role, you will be responsible for administering our employee pharmacy benefit programs, providing essential support to our employees, and ensuring the smooth operation of our benefits system. The ideal candidate will have strong administrative skills, a solid understanding of pharmacy benefits, and a commitment to providing exceptional service.
Key Responsibilities
- Administer and maintain all aspects of the organization's pharmacy benefit programs for employees.
- Act as the primary point of contact for employee inquiries regarding pharmacy benefits, eligibility, and claims resolution.
- Liaise effectively with pharmacy benefit managers (PBMs), insurance carriers, and other third-party vendors to resolve issues and optimize plan performance.
- Process and verify pharmacy claims, ensuring accuracy and compliance with plan provisions.
- Educate employees on plan changes, enrollment options, and proper utilization of pharmacy benefits.
- Maintain accurate and confidential employee benefits records within HRIS systems.
- Assist with benefits enrollment, changes, and termination processes related to pharmacy benefits.
- Prepare reports and analyze data related to pharmacy benefit utilization and costs.
- Ensure compliance with all relevant federal and state regulations pertaining to pharmacy benefits and HR administration.
Required Skills
- Excellent written and verbal communication skills with a strong customer service orientation.
- Demonstrated ability to manage multiple tasks, prioritize effectively, and meet deadlines in a fast-paced environment.
- Strong analytical and problem-solving skills with meticulous attention to detail.
- Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
- Basic understanding of pharmacy benefits, prescription drug plans, and insurance terminology.
- Ability to handle sensitive and confidential information with discretion and integrity.
- Minimum of 2 years of experience in an administrative support role, preferably within HR, benefits, or healthcare administration.
Preferred Qualifications
- Associate's or Bachelor's degree in Human Resources, Healthcare Administration, Business Administration, or a related field.
- Experience with HR Information Systems (HRIS) and benefits administration software.
- Knowledge of federal and state regulations (e.g., ERISA, HIPAA, ACA) related to benefits.
- Certification in benefits administration (e.g., CEBS) or a relevant professional designation.
Perks & Benefits
- Comprehensive health, dental, and vision insurance options.
- 401(k) retirement plan with generous company match.
- Paid time off (PTO) and company-paid holidays.
- Employee wellness programs and resources.
- Opportunities for professional development and continuing education.
- Employee assistance program (EAP).
- On-site fitness center and cafeteria services.
How to Apply
If you are interested in this position, please click the "Apply Now" button below. To ensure your application is properly considered, please prepare the following:
- An up-to-date Resume or CV
- A brief cover letter summarizing your experience and motivation
Applications are reviewed on a rolling basis. Only shortlisted candidates will be contacted for an interview.
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