- Humana (Atlanta, GA)
- …of our caring community and help us put health first** Job Description Summary The Pharmacy Claims Representative assists local pharmacies with claims ... in setting up and maintaining hospice/facility/ pharmacy relationships under the direction of the Pharmacy Claims Team Leaders & the Pharmacy Claims … more
- Mayo Clinic (Rochester, MN)
- … or durable medical equipment billing and collection activities, or certified pharmacy tech with 2 years of experience.Qualified candidate must possess ... expert for one or more of the following business lines: outpatient pharmacy , durable medical equipment, skilled nursing facility, home health agency or continuing… more
- Providence (Portland, OR)
- … Technician License OR Oregon Certified Pharmacy Technician. + 2 years experience with insurance verification, medical claims processing, insurance ... **Description** We are seeking a Pharmacy Technician Access Services Representative to...member enrollment or customer service. + 2 years experience as a pharmacy technician… more
- BrightSpring Health Services (Louisville, KY)
- …customer service. What we are looking for: + Experience in Customer Service + Required: 2 + yrs experience as a Pharmacy Technician or in a billing position ... career progression! Step Into a Rewarding Role as a Claims Analystwith PharMerica! The3rd Party Claims Analystis...is required + Desired: Associate or Bachelor's degree + 2 + yrs experience as a Pharmacy Technician… more
- Molina Healthcare (Spartanburg, SC)
- …or exceed the Plan's monthly site visit goals. A key responsibility of the Representative during these visits is to proactively engage with the provider and staff to ... as they arise, making an assessment when escalation to a Senior Representative , Supervisor, or another Molina department is needed. Takes initiative in preventing… more
- AmeriHealth Caritas (Harrisburg, PA)
- **Role Overview:** The Provider Network Contract Representative oversees the daily operations related to Out of Network (OON) agreements, provider contracts, and ... 8040 Carlson Road, Harrisburg, PA 17112, at least two ( 2 ) days per week on Tuesdays and Wednesdays. **Responsibilities:**...to ensure accurate provider setup in systems and proper claims payment. + Adhere to all organizational policies, including… more
- TEKsystems (Tempe, AZ)
- …years of high-touch, patient facing healthcare service roles (eg, Patient Access Reps, Claims Processors, Pharmacy Benefits Techs, etc.) * Strong written and ... with One Medical* Overview This is an inbound healthcare contact center representative role working for a nationwide primary care practice. Description + Managing… more
- State of Colorado (Denver, CO)
- …modules, processing medical claims and encounters, member eligibility, medical and pharmacy prior authorizations, pharmacy claims , third party liability ... in a large claims processing system and/or knowledge of Medicaid and Pharmacy benefits and services. + A proven track record in program management assisting in… more
- Publix (Lakeland, FL)
- …operates, and + Associate of Risk Management designation or Certified Claims Representative Designation. **Zip Code:** 33811-3311 **Benefits Information:** + ... diverse range of legal matters, including general liability, product, fleet, and pharmacy lawsuits, across the eight states where Publix operates. The General… more
- The Cigna Group (Tampa, FL)
- …on Workers Compensation PBM, the market environment, and the interactions with claims payers. The Account Executive works closely with Marketing, Clinical Team, ... 6+ years of relevant experience + Both to include 2 + years of medical sales experience with proven track... years with proven track record as a Sales Rep MS Office, + Computer proficiency Knowledge of managed… more
- LA Care Health Plan (Los Angeles, CA)
- …etc. Collaborates with internal departments (Member Services, Provider Network Operations, Claims , Utilization Management, Pharmacy , and Quality Management) to ... ( Claims , Provider Network Operations, Utilization Management, Quality Management, Pharmacy ) to appropriately address and resolve member grievances. Serve as the… more
- Essentia Health (Superior, WI)
- …continuous improvement Preferred Qualifications: + 2 years' experience as a pharmacy technician, medical assistant, claims representative in a managed ... Health. Will work with clinic departments and other departments within ambulatory pharmacy to create and maintain best practices, performance standards, and quality… more
- BD (Becton, Dickinson and Company) (Covington, GA)
- …, licensing, and regulatory submissions is a plus. + Experience as a designated representative with state boards of pharmacy is a plus. Knowledge and Skills ... all products, safeguarding their integrity throughout the distribution chain. Customer Quality Claims Resolution + Investigate and resolve any claims regarding… more
- Grifols Shared Services North America, Inc (Research Triangle Park, NC)
- …needs of its patients as well as healthcare professionals working in therapeutics, pharmacy , diagnostics and blood banking. For more than 100 years, Grifols has ... information, please visit our website: http://www.grifols.com This position is hybrid (3 days onsite/ 2 days WFH) Full Time position at RTP, NC. You must be local.… more
- Avera (Sioux Falls, SD)
- **Location:** Avera Long Term Care Pharmacy **Worker Type:** Regular **Work Shift:** Day Shift (United States of America) **Pay Range:** _The pay range for this ... the preparation, completion and filing of third party payor insurance reimbursement claims , both electronic and paper formats. + Processes explanation of Medicare… more