- Essentia Health (Superior, WI)
- …340B programs. + Develop a thorough understanding of the split-billing/ third party administrator systems, including claims qualification logic, system ... external relationships (wholesalers, manufacturers, contract pharmacies, split-billing software vendors, and third - party administrator vendors) as needed +… more
- SSM Health (MO)
- …ministries. + Reviews ordering, negative and positive accumulations and unmapped items in third - party administrator 's ( TPA ) portal. + Ensures compliant ... Requirements:** PRIMARY RESPONSIBILITIES + Performs recurring internal audits and oversight of 340B contract pharmacy programs, inpatient pharmacy programs, child… more
- Baylor Scott & White Health (Columbus, OH)
- **JOB SUMMARY** The Risk Adjustment Analyst Sr (Texas Medicaid Encounter Analyst ) is responsible for monitoring and oversight of the end-to-end encounter ... OF THE ROLE** + Monitors and oversees the end-to-end claims encounter management workflow. + Analyzes claims ...complex claim processing. + Knowledge of ACA, Medicaid, MCO, TPA business requirements preferred + Excellent time management and… more