- 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. + Enter and correct service authorizations for… 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
- Peak Vista (Colorado Springs, CO)
- …met to include Health Resources Services Administration (HRSA), Federal Tort Claims Act (FTCA), Accreditation Association of Ambulatory Health Care (AAAHC), ... processes, root cause analysis, risk assessments, audits, analysis of trends, claims analysis and review of pertinent quality improvement information with a… 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