• Pharmacy Claims Specialist

    Hackensack Meridian Health (Eatontown, NJ)
    …of prescription claims . **Responsibilities** A day in the life of a Pharmacy Claims Specialist at Hackensack Meridian _Health_ includes: 1. Submit ... and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how...a leader of positive change. Responsible for long-term care pharmacy third party billing functions as assigned by the… more
    Hackensack Meridian Health (01/04/25)
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  • Pharmacy Benefit Specialist

    Intermountain Health (Murray, UT)
    **Job Description:** The Pharmacy Benefit Specialist I is responsible for the day-to-day operations of Commercial programs, providing superior customer ... Qualifications Demonstrated experience in any of the following: + Medical/ pharmacy claims processing. + Health benefit... Benefits Management (PBM) + Medical Prescriptions + Pharmacy Claims + Call Center + Customer… more
    Intermountain Health (01/22/25)
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  • Specialist 3rd Party Rx Ops Pharmacy

    Walgreens (Deerfield, IL)
    …viewing presentations). **Preferred Qualifications:** + At least 2 years experience in pharmacy claims processing. We will consider employment of qualified ... Equal Opportunity Employer, including disability/veterans". **Job ID:** 1503865BR **Title:** Specialist 3rd Party Rx Ops Pharmacy Tech...and at least 1 year of experience in retail pharmacy , medical claims processing, and/or third party… more
    Walgreens (01/07/25)
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  • Specialist 3rd Party Rx Ops Pharmacy

    Walgreens (Deerfield, IL)
    …viewing presentations). **Preferred Qualifications:** + At least 2 years experience in pharmacy claims processing. We will consider employment of qualified ... Equal Opportunity Employer, including disability/veterans". **Job ID:** 1523205BR **Title:** Specialist 3rd Party Rx Ops Pharmacy Tech...and at least 1 year of experience in retail pharmacy , medical claims processing, and/or third party… more
    Walgreens (12/20/24)
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  • Claims Specialist

    PSKW LLC dba ConnectiveRx LLC (Whippany, NJ)
    Overview The Claims Specialist , under the direction of the Supervisor (with guidance from a Team Lead), is responsible for processing medical claims received ... 1+ years in a health care or case management setting + Experience working in pharmacy benefits , health care insurance, and/or medical billing a must + Health… more
    PSKW LLC dba ConnectiveRx LLC (01/17/25)
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  • Pharmacy Operations Specialist

    Medical Mutual of Ohio (OH)
    …and Federal Drug Laws. . Strong knowledge of pharmacy and medical drug benefits , PBM claims processing and benefit set-up requirements. . Knowledge of ... Operations, Benefit Services, Communications, and the Pharmacy Benefit Manager (PBM) to bridge the... claims processing following audit workplan, and tests claims for selected benefits , programs, or groups… more
    Medical Mutual of Ohio (01/10/25)
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  • Pharmacy Billing Specialist

    Elderwood (Buffalo, NY)
    Pharmacy Technician experience in retail, long term care or hospital. + Experience with Pharmacy claims and various types of pharmacy billing preferred + ... Salary Starting at $18.00 / hour Overview Pharmacy Billing Specialist Starting Pay Rate...electronic billing of Medicare, Medicaid and Third Party Insurance claims , utilizing Frameworks LTC Pharmacy system. This… more
    Elderwood (12/23/24)
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  • Claims (Medicaid) Eligibility…

    AmeriHealth Caritas (Robbinsville, NJ)
    …efficiency, and integrate services. For more;information, visit www.performcare.org **Summary:** The Claims Eligibility Specialist is the point of contact for ... to resolving discrepancies in coverage, eligibility, enrollment, and billing, the Claims Eligibility Specialist reviews, researches, and investigates claims more
    AmeriHealth Caritas (01/03/25)
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  • Healthcare Claims Specialist

    BrightSpring Health Services (Oklahoma City, OK)
    …healthcare professionals. The Adjudication Specialistwill be responsible for all aspects of pharmacy and medical claims adjudication, accuracy of pharmacy ... and medical claims , resolution of third-party rejections, and coordination of benefits . SCHEDULE: Monday - Friday 10:00am - 6:30pm * Medical, Dental & Vision … more
    BrightSpring Health Services (12/31/24)
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  • Healthcare Claims Denials Specialist

    CenterWell (Jefferson City, MO)
    …one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing ... help us put health first** As an **Accounts Receivable Specialist ** , you will: + Ensure the coordination of...timely reimbursement of receivables. + Research, resolve, and prepare claims that have not passed the payer edits daily.… more
    CenterWell (01/17/25)
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  • Recovery Specialist (Accountant I - Medical…

    TEKsystems (Murray, UT)
    …. + Accurately evaluates the correct adjustments for medical, historical, regular claims adjustments, and pharmacy claims adjustments. Processes basic ... checks from providers, insured members, and third parties. Accurate correction of claims history and medical expense accounts. + Researches and accurately applies… more
    TEKsystems (01/18/25)
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  • Retail Pharmacy Business Specialist

    Sanford Health (Fargo, ND)
    …time **Weekly Hours:** 40.00 **Salary Range:** $15.00 - $23.00 **Job Summary** The Pharmacy Business Office Specialist , supports retail pharmacy operations. ... , this could be the place for you. The Pharmacy Business Specialist is a unique position...- CARS (Cash Reconciliation Solutions) - Tills - Insurance benefit verification for our Home Infusion book of business… more
    Sanford Health (12/26/24)
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  • Billing & Insurance Specialist

    Ardon (Portland, OR)
    …applications. Ability to work in a fast-paced environment. Knowledge of pharmacy benefit investigation, prior authorization support, and patient financial ... to grow, we are seeking a Billing & Insurance Specialist to join our award-winning specialty pharmacy ...Team member, you will conduct insurance reviews, process prescription claims , and communicate with benefit providers, patients,… more
    Ardon (11/02/24)
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  • Pharmacy Access Specialist

    SSM Health (Madison, WI)
    …the healing power of presence begins with compassionate employees like you. As a Pharmacy Access Specialist , you've chosen a career where patients matter-a lot. ... The Pharmacy Access Specialist plays an integral role...a thorough understanding of payer reimbursement and patterns for pharmacy and medical claims with third parties.… more
    SSM Health (01/04/25)
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  • Pharmacy Business and Revenue Cycle…

    Prime Healthcare (Aurora, IL)
    …Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf Responsibilities The Pharmacy Business and Revenue Cycle ... Specialist is responsible for ensuring that pharmacy related systems and processes for revenue cycle are...key stakeholders to develop appeals or redeterminations for any claims that require a review of medical necessity, disease… more
    Prime Healthcare (12/12/24)
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  • Pharmacy Provider Fee Specialist

    Louisiana Department of State Civil Service (Baton Rouge, LA)
    …Opening Date 11/25/2024 + Description + Benefits Supplemental Information Please clickHERE (https://ulsuno.wd1.myworkdayjobs.com/en-US/UniversityOfNewOrleans/job/ ... Pharmacy Provider Fee Specialist Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4741115)...+ Communicates with the Louisiana Department of Insurance when Pharmacy Benefit Managers (PBM) are found to… more
    Louisiana Department of State Civil Service (11/26/24)
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  • Contract Specialist - Pharmacy

    Fairview Health Services (Minneapolis, MN)
    **Overview** As a member of the pharmacy team, the Contract Specialist manages and coordinates all financial information with third party plans to ensure ... customer service, problem solving and collaboration skills to support and manage pharmacy revenue management activities. The Contract Specialist will also be… more
    Fairview Health Services (12/24/24)
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  • Sr. Collections Specialist

    Publix (Lakeland, FL)
    … unsaleables process + Responsible for managing and improving the aging report on unpaid pharmacy claims , collecting money for all pharmacy 3rd party sales ... **31221BR** **Position Title:** Sr. Collections Specialist - Pharmacy , Accounts Receivable -...Annual Base Pay:** 40,872 - 56,368 **Zip Code:** 33811-3311 ** Benefits Information:** + Employee stock ownership plan that contributes… more
    Publix (12/11/24)
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  • Pharmacy Access Specialist

    SSM Health (St. Louis, MO)
    …authorization services. Develops a thorough understanding of payer reimbursement and patterns for pharmacy and medical claims with third parties. + Serves as ... include but are not limited to third party payers, manufacturers, prescription benefit management companies, external pharmacy personnel, and referring providers… more
    SSM Health (01/09/25)
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  • Pharmacy Access Specialist PRN

    SSM Health (Madison, WI)
    …authorization services. Develops a thorough understanding of payer reimbursement and patterns for pharmacy and medical claims with third parties. + Serves as ... include but are not limited to third party payers, manufacturers, prescription benefit management companies, external pharmacy personnel, and referring providers… more
    SSM Health (11/23/24)
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