- Excellus BlueCross BlueShield (Rochester, NY)
- …the pharmacy help desk, customer care and claim processors to coordinate pharmacy and/or medical claims with prior authorization information on file or ... right for you, we encourage you to apply! Job Description: Summary: The Pharmacy Prior Authorization Technician performs functions as permitted by law including the… more
- CVS Health (Nashville, TN)
- …adjudication principles, such as (but not limited to) benefit setup, prior authorizations, claims payment, and pharmacy contracting in order to review and ... respond to all the auditor questions in a short window of time. This...will possess the following: . A deep understanding of pharmacy claim adjudication. . Ability to actively seek new… more
- MyFlorida (Tallahassee, FL)
- … and contract manager for the state group insurance program's post payment claims audits and the Pharmacy Benefits Manager compliance audit. This position ... be knowledgeable and experienced in auditing and monitoring, financial and claims data analysis, data collection methods, generally accepted accounting principles,… more
- Option Care Health (Bannockburn, IL)
- …to analyze large datasets, such as related to healthcare operations, billing, claims , and patient information to support Compliance activities and to identify ... methodologies. + Certified in Healthcare Compliance (CHC), Certified Internal Auditor (CIA), Certified Fraud Examiner (CFE), or similar certification preferred.… more
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