- Humana (Lincoln, NE)
- **Become a part of our caring community and help us put health first** The Pharmacy Claims Representative assists local pharmacies with claims ... up and maintaining hospice/facility/ pharmacy relationships under the direction of the Pharmacy Claims Team Leaders & the Pharmacy Claims (Support… more
- IQVIA (Phoenix, AZ)
- **Experienced Patient Support Medical Claims Processing Representative ** _Contract Remote Role - Location (Open to Remote US)_ As the only global provider of ... are looking for a 100% remote (work from home-WFH) contact **Patient Support Medical Claims Processing Representative ** to join our team. In this position, you… more
- Apex Health Solutions (Houston, TX)
- Position Summary: The Pharmacy Care Representative performs duties to support the efforts of the pharmacy operations and solutions department in the ... health plan's pharmacy benefits and services. The Pharmacy Care Representative is primarily responsible for...NCQA guidelines, and CMS standards. Explains Point of Sale claims adjudication, state, NCQA, and CMS policy/guidelines, and any… more
- Mount Sinai Health System (New York, NY)
- …the WTCH clinic population. The Clinical Pharmacy Manager will act as the pharmacy representative for the WTCHP clinic(s) in coordination with other MSHS ... prescription portal for QA report and analyzing + Reviewing pharmacy claims to identify outliers, utilization and...supervisor, subject to reasonable accommodation . + Serve as pharmacy representative on behalf of MSHP as… more
- Highmark Health (Harrisburg, PA)
- …coordination of benefit billing practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + ... **Minimum** + High school diploma or GED + Experience in pharmacy prescription claims processing/submission/payment. **Preferred** + Associate degree +… more
- Aston Carter (Dearborn, MI)
- Job Title: Workers Compensation Claims Assistant III Job Description Responsible for entering medical and miscellaneous invoices into the MBP (Medical Bill Payment) ... pay or deny bills as indicated by the Workers' Compensation Plant Representative . + Communicate with vendors and Workers' Compensation Plant Representatives to… more
- Sharp HealthCare (San Diego, CA)
- …shift.Assists lead technician in processing daily, weekly and monthly reports and claims within the designated time frames.Performs pharmacy computer back-up ... Per Diem **Shift** Day **FTE** 0 **Shift Start Time** **Shift End Time** California Pharmacy Technician License (TCH) - CA State Board of Pharmacy ; Certified … more
- Owens & Minor (Salt Lake City, UT)
- …Experience: + High school diploma or equivalent; + Experience in Third Party Claims processing; + Knowledge in pharmacy operations and products utilized by ... and patients. + Verify all patient demographics including shipping address, pharmacy insurance coverage, allergy and medical conditions as necessary. + Contact… more
- Priority Health Care (Gretna, LA)
- …prescribed drug therapy is followed as prescribed and coordinate patients prescribed pharmacy care with their healthcare providers to ensure that drug therapy is ... (PIC) of stock needs and shortages. + Process Medicare, Medicaid, and Insurance claims . + Must have working knowledge of pharmaceutical calculations. + Able to add,… more
- SpartanNash (Kearney, NE)
- …service, utilizing the computer systems to maintain patient profiles and insurance claims , and checking out patients that ensures that the shift contributes to ... take inventory of medications (prescription and over the counter). + Notify Pharmacy Manager of supplies/products that need to be ordered. + Receive… more