• Pharmacy Claims

    Dragonfly Health (Mesa, AZ)
    pharmacy relationships and demographics. 10. Complete tasks and special projects assigned by Pharmacy Claims Team Leaders on Pharmacy Claims (Support ... of six (6) months of pharmacy technician experience. * Experience with pharmacy claims adjudication is required. Specialized Knowledge, Skills & Abilities: *… more
    Dragonfly Health (09/10/25)
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  • Pharmacy Technician Associate…

    The Cigna Group (Phoenix, AZ)
    …home position that must reside **within the state of** **Arizona.** As a ** Pharmacy Technician** with Freedom Fertility, you will be assisting patients in receiving ... + Accurately enter prescriptions into our system, run test claims , run test claims and support patients...experience or a willingness to learn. + **Valid National Pharmacy Technician certification is required.** + **Valid Arizona State… more
    The Cigna Group (10/01/25)
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  • Pharmacy Technician I

    Peak Vista (Colorado Springs, CO)
    Pharmacy Technician I Summary Title: Pharmacy Technician I ID:0919-4800 Department Location: Pharmacy at Union, 225 S. Union Blvd, Colorado Springs, CO 80910 ... Rewards + Employee Assistance Program https://www.peakvista.org/resources/benefits-summary Job Summary: Supports pharmacy operations and pharmacists in the provision of … more
    Peak Vista (09/21/25)
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  • Patient Benefit Representative

    Adecco US, Inc. (Cary, NC)
    …Track and follow up on authorization requests to ensure timely responses * Process pharmacy claims in the management system and maintain accurate records * ... **Now Hiring: Patient Benefit Representative ** Adecco Healthcare & Life Sciences is seeking...: $20-$25/hour (top rate available for CPhT-certified candidates with 2 + years retail pharmacy & customer service… more
    Adecco US, Inc. (10/02/25)
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  • Customer Care Representative - SHP…

    Sharp HealthCare (San Diego, CA)
    …Premium billing reminders and payment processing.* Member education.* Member claims investigation and resolution.* Pharmacy prior authorizations and ... of six (6) months experience as a Customer Call Center Representative . **Preferred Qualifications** + Associate's degree business administration or health care… more
    Sharp HealthCare (10/04/25)
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  • Patient Benefit Representative

    Adecco US, Inc. (Cary, NC)
    …a full-time **Key Responsibilities:** * Conduct benefits investigations and adjudicate pharmacy claims * Communicate with providers regarding prior ... **Now Hiring: Patient Benefit Representative ** Adecco Healthcare & Life Sciences is seeking...timely and compliant service **What We're Looking For:** * 2 + years of experience in pharmacy or… more
    Adecco US, Inc. (10/04/25)
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  • Provider Relations Representative (Travel…

    Molina Healthcare (Ramapo, NY)
    …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
    Molina Healthcare (09/12/25)
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  • Medication Access Associate I (80 hours per pay…

    Essentia Health (Superior, WI)
    …(CPhT, CMA, etc.) Preferred Qualifications: + 2 years' experience as a pharmacy technician, medical assistant, claims representative in a managed care ... as assigned Required Qualifications: + 1 year experience as a pharmacy technician, medical assistant, claims representative in a managed care role or in… more
    Essentia Health (09/25/25)
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  • Grievances and Appeals 3

    CenterWell (Raleigh, NC)
    …caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a comprehensive analytic ... clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced administrative/operational/customer support duties that require… more
    CenterWell (10/03/25)
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  • Outpatient Staff Pharmacist

    Trinity Health (Ankeny, IA)
    …**Description:** This Outpatient Staff Pharmacist position is located at our onsite pharmacy in Ankeny, IA. JOB SUMMARY / PURPOSE Provide patient focused, outcome ... changes in therapy as appropriate. * Participate in and deliver specialty pharmacy care management activities, as appropriate * Answer drug information questions. *… more
    Trinity Health (09/27/25)
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  • Liability Attorney, Risk Management

    Publix (Lakeland, FL)
    …and bar admission in other Publix-operating states. + ARM or Certified Claims Representative designation. **Zip Code:** 33811-3311 **Work Environment:** Hybrid ... a wide range of liability matters including premises, fleet, pharmacy , and product claims . + Develop and...(lead or second chair), OR3 years in litigation + 2 years managing litigation for a corporate liability function,… more
    Publix (08/22/25)
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  • Medication Access Supervisor

    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
    Essentia Health (09/23/25)
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  • Post-Doctoral Regulatory Affairs Fellow…

    Boehringer Ingelheim (Ridgefield, CT)
    …for our employees. The Fellow will serve as the Regulatory Affairs representative on the Human Pharma Review Committee (HPRC) team, working cross-functionally with ... and the current Regulatory landscape. The Fellow will review promotional claims and materials for Boehringer Ingelheim prescription drugs for compliance with… more
    Boehringer Ingelheim (08/30/25)
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  • Coord Appeals & Grievances

    AmeriHealth Caritas (Newark, DE)
    …integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. ... tasks for coordination of member and/or provider appeals, the analysis of claims and appeals, and the review of medical management authorizations.; + Research… more
    AmeriHealth Caritas (09/03/25)
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  • Estate Case Manager I/II

    Clark County, NV (Las Vegas, NV)
    …desirable. Estate Case Manager II - In addition to the above: Two ( 2 ) years of full-time professional level experience managing estate guardianships is required. ... obtain and maintain a valid National Center for Guardianship Certification within two ( 2 ) years from date of hire, excluding Case Managers assigned exclusively to… more
    Clark County, NV (10/01/25)
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  • House Lead - Health Care Tech III - Pueblo…

    State of Colorado (Pueblo, CO)
    …potential problems. Department Standards: + Knows, utilizes, and follows: Pharmacy Formulary, treatment plans, Infection Control manual, Physician's orders, Court ... meet education and mandatory training requirements. + Reports abuse allegations, claims of harassment/workplace violence immediately to the Emergency On Call… more
    State of Colorado (09/23/25)
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  • National Accounts: Dedicated Field Services…

    CVS Health (Boston, MA)
    …as well as navigating them through the health system, providing support on claims issues, and answering coverage-level questions. **We have two of these roles to ... role will be expected to be onsite in NYC 2 - 3 times per week and upon the...benefits related issues including answering routine questions, addressing denied claims , preauthorization, and providing support to both the employees… more
    CVS Health (09/06/25)
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  • Investigator I, Investigator II, And Investigator…

    State of Massachusetts (Boston, MA)
    …care settings.The Investigator will: review complaints against providers; access Medicaid claims and conduct data analysis; research program rules and regulations; ... equivalent experience, preferred. . Experience requirements by level: 1. Investigator I: 0- 2 years of relevant experience. 2 . Investigator II: 3-4 years… more
    State of Massachusetts (09/22/25)
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  • Purchasing Agent

    Community Wellness Partners (Oswego, NY)
    …in accordance with established policies and procedures. + Interview sales representative and select vendors/suppliers in accordance with established policies and ... and implement recommendations from the facility's committees, eg Quality Assurance, Pharmacy , Infection Control, etc. + Check invoices, purchase orders, packing… more
    Community Wellness Partners (09/30/25)
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  • Billing Associate

    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
    Avera (08/22/25)
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