Rx Claims SME
Eden Prairie, MN
Date Posted:08-Jun-2026
Work Type:On-Site
Job Number:487268
Job Description
Job Title: Rx Claims SME
Location: Eden Prairie, MN 55344 (Hybrid)
Duration: 12 months
Job Description:
In depth knowledge on RxClaim Adjudication, claims processing, MedD claims
Deep knowledge of PBM concepts, including drug pricing, copays, accumulators, and Drug Utilization Review (DUR)Knowledge on business & plan configuration and plan option knowledge.
Facilitate discussion with Product Owners, Business and clarify business requirements
High level knowledge in executing root cause analysis, managing data validation, and navigating automated database systems/reporting tools.
Experience:
10 Years of Relevant Experience.
Applicant Notices & Disclaimers
- For information on benefits, equal opportunity employment, and location-specific applicant notices, click here
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position's pay range is $60.00/hr – $62.00/hr.