- Bon Secours Mercy Health (Cincinnati, OH)
- …members, and deliver response letters to members and providers + Analyzes and audit pharmacy claims with a focus on but not limited to significant changes ... operational excellence. **Remote Position** **Primary Function/General Purpose of Position** The Pharmacy Business & Performance Analyst will assist in… more
- Pharmacy Data Management, Inc. (OH)
- PDMI is looking for a Benefits Configuration Analyst to join our team! This role requires full knowledge of product-specific plan designs and benefit structures ... product lines related to their specific product designation. The Benefits Configuration Analyst must understand the specific products within their control and is… more
- The Cigna Group (Seattle, WA)
- …contractual requirements. **ESSENTIAL FUNCTIONS** + Perform efficient and effective network pharmacy claims audits to produce results consistent with ... of claims audited. + Utilizing personal knowledge of medications, prescription validity and available tools including the CSP, Access, Excel, Teradata etc.,… more
- Sharp HealthCare (San Diego, CA)
- …for the post-acute patient population under the Home Infusion and Specialty Pharmacy programs. Including billing and collections to all payers through resolution of ... setting. **Essential Functions** + Teamwork and CollaborationWork directly with onsite pharmacy technicians and clinical evaluator to complete all aspects of the… more
- G-TECH Services, Inc. (Detroit, MI)
- …existing software packages (Excel, Power Point, Word, Outlook, etc.) * Knowledge of claims processing and prescription drug names Required Skills * Working ... or committee discussions. * Supports PBM audit and analytics to support Medicare pharmacy services business team. * Builds and supports business reports to be… more
- IQVIA (Milwaukee, WI)
- …not required: o Chargeback Adjudication o Membership and Eligibility determinations o Prescription Rebate Processing o Pharmacy Benefit Management o Managed ... your clients. Those skills are pertinent because as an analyst , you will be responsible for multiple accounts and...writing with a customer. o Research and resolve Chargeback claims . o Ensure accurate and appropriate responses to disputes.… more