- CVS Health (Austin, TX)
- …And we do it all with heart, each and every day. Reviews and adjudicates routine claims on HRP system in accordance with claim processing guidelines. Claims ... Aetna compliance and business requirements. Analyzes and approves routine claims that cannot be auto adjudicated. - Applies medical...applies all cost containment measures to assist in the claim adjudication process. - Proofs claim or… more
- Molina Healthcare (Dallas, TX)
- …+ Review and interpret member's eligibility, claim history, and pharmacy benefit information using the PBM claims software to provide information to ... **JOB DESCRIPTION** **Job Summary** The Specialist , Pharmacy Operations is responsible for the oversight...be the primary contact for affiliated health plans, Pharmacy Benefit Managers and Corporate shared services with respect to… more