Client Services Pharmacy Support Analyst

Capital Blue Cross

. Research and review customer inquiries related to vendor lines of business .

Posted 10/1/2026full-timeRemote • Pennsylvania • United StatesMid-LevelSenior💰 $19 - $35 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in customer service, benefits administration, and claims processing while effectively communicating and resolving inquiries. Proficient in utilizing various software tools and understanding regulatory requirements related to health information.

Highest-signal resume keywords

Customer Service ExperienceBenefits Administration KnowledgeClaims Processing ExpertiseHIPAA Compliance UnderstandingProficiency in Windows and Office Software

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Benefits AdministrationClaims ProcessingCustomer Inquiry ResolutionAnalytical SkillsProblem-Solving SkillsKnowledge of Medicare ProgramsKnowledge of ERISA RegulationsProficiency in ExcelProficiency in WordProficiency in Sales Force

Soft Skills

Effective CommunicationOrganizational SkillsAdaptabilityProfessionalismInstructional Skills

Tools & Technologies

PCSales ForceFacetsWindowsOutlookWordExcelPowerPointSharePointInternet Explorer

Industry Keywords

HIPAAMedicare AdvantageMedicare Part DCOBRABenefits ManagementDisease ManagementBillingLegal RequestsAccount AdministrationERISA

About the role

Key responsibilities & impact

Research and review customer inquiries related to vendor lines of business
Interpret applicable policies and procedures and determine appropriate actions
Obtain benefits, enrollment, and claims information using PCs, manuals, online references, Imaging, and other systems
Resolve routine and complex inquiries involving benefits, claims, billing, enrollment, legal requests, Medicare Secondary Payer, COBRA, reinstatements, conversions, refunds, and related issues
Conduct job-related instructional sessions as requested
Respond to customers via telephone, correspondence, on-site interactions, fax, Secure IT, email, and personal interviews
Monitor vendor inquiries through system-generated reports for timely and accurate resolution
Provide instructions to appropriate plan areas for issue resolution
Contact internal and external entities to obtain information and initiate action
Update Facets inquiries, Sales Force cases, and Work Desk records and maintain progress notes
Report trends and processing problems to management
Support Marketing personnel and brokers by researching and communicating customer information
Participate in marketing activities such as open enrollment and on-site visits
Complete ongoing training and learn new skills
Recognize, document, and report customer-service trends to the supervisor
Maintain conduct consistent with organizational values

Requirements

What you’ll need

3 years customer service or correspondence experience, or experience/training in a writing-intensive role
High School degree or equivalent
Customer interaction experience preferred
Ability to communicate effectively and professionally verbally and in writing
Ability to understand and interpret detailed policies and procedures
Understanding of HIPAA requirements for protecting Protected Health Information
Ability to work independently and adapt to changing assignments and work environments
Analytical, organizational, and problem-solving skills
Proficiency operating a PC and associated software and office equipment
Competency in Windows, Outlook, Word, Internet Explorer, Excel, PowerPoint, SharePoint, and Sales Force
Above average reading, writing, and arithmetic skills
Knowledge of Medicare Advantage, Medicare Part D, Medicare Supplemental Programs, Dental, Vision, Chiropractic, Prescription Drug, Benefits Management, and Disease Management
Knowledge of PBM and Facets health plan administration processing systems
Knowledge of benefits administration, billing, claims processing, ERISA, Act 68, BCBSA MTM, PPACA, HIPAA, and Account Administration regulations
Ability to work 37.5 hours per week, including flexible schedules, nights, and weekends based on business needs

Benefits

Comp & perks

Medical, Dental & Vision coverage
Retirement Plan
Paid Time Off
Holidays
Volunteer time off
Incentive Plan
Tuition Reimbursement
Flexible schedules
Training and continuing education
Professional and personal growth opportunities
Community volunteering opportunities