1 claims operations analyst jobs found in Cadillac, MI

The Claims Consultant supports the administration and processing of pharmacy benefit claims for self-funded employer health plans. This role serves as a key liaison between clients, plan members, pharmacies, pharmacy benefit managers (PBMs), third-party administrators (TPAs), and internal teams to ensure claims are processed accurately, efficiently, and in accordance with plan provisions and regulatory requirements. The Claims Consultant plays a critical role in analyzing claim issues, resolving discrepancies, identifying cost-saving opportunities, and delivering exceptional service to clients and stakeholders. This position contributes directly to ARORx's mission of helping self-funded organizations optimize pharmacy benefits, manage costs, and improve plan performance. Responsibilities: • Review, investigate, and resolve pharmacy benefit claim issues and inquiries in a timely manner. • Analyze claim adjudication outcomes and identify discrepancies, processing errors, and...