• Pharmacy Claims Specialist

    BrightSpring Health Services (Uniondale, NY)
    Our Company PharMerica Overview Make the Move to PharMerica- Claims Specialist Opportunity! Ready to take your pharmacy experience to the next level? ... dedication. + Health, Dental, Vision, and Life Insurance: Comprehensive benefits to keep you covered. + Company-Paid Short &...Party: + Manages and identifies a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement… more
    BrightSpring Health Services (09/03/24)
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  • Claims Specialist

    Randstad US (Earth City, MO)
    claims specialist . + earth city , missouri + posted october 16, 2024 **job details** summary + $30 - $35 per hour + temp to perm + associate degree + category ... growing team located in Earth City, MO, 63045. The claims specialist will be responsible for working...education: Associate Responsibilities + Conduct quality assurance audits of pharmacy claims , vendor files, and operations tickets… more
    Randstad US (10/16/24)
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  • Claims And Billing Specialist

    TEKsystems (Cary, NC)
    Specialist opportunity in Cary, North Carolina! Job Description: The Reimbursement Specialist is an important role in the Pharmacy Operations and is ... degree preferred. + Candidate should have 1+ years experience of the following): + Claims Processing ( Pharmacy ) + Reimbursement ( Pharmacy ) + Customer Service… more
    TEKsystems (10/31/24)
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  • Healthcare Claims Denials Specialist

    CenterWell (Topeka, KS)
    …one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing ... of our caring community and help us put health first** As an **Accounts Receivable Specialist /Healthcare Claims Denials Specialist ** , you will: + Ensure the… more
    CenterWell (10/30/24)
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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 (09/06/24)
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  • Project Specialist - Texas All-Payor…

    UT Health (Houston, TX)
    Project Specialist - Texas All-Payor Claims Database - Hybrid **Location:** Texas Medical Center-Houston, Texas **Hot** **Category:** Engineering UTHealth ... come in. **We are looking for a Full-Time Project Specialist to join the UTHealth School of Public Health...Database (TX-APCD) project, which collects administrative data for medical, pharmacy , and dental claims along with eligibility… more
    UT Health (09/26/24)
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  • Pharmacy Operations Specialist

    Molina Healthcare (Covington, KY)
    …+ Review and interpret member's eligibility, claim history, and pharmacy benefit information using the PBM claims software to provide information to ... will be the primary contact for affiliated health plans, Pharmacy Benefit Managers and Corporate shared services...+ Excellent observation and communication skills + Comfortable monitoring pharmacy claims and reporting to the Healthplan… more
    Molina Healthcare (11/03/24)
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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 (08/15/24)
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  • Pharmacy Billing Specialist

    Robert Half Accountemps (Indianapolis, IN)
    … Billing Specialist , you will be responsible for handling all aspects of pharmacy claims and ensuring timely collection of payments for pharmacy ... Description We are in search of a Pharmacy Billing Specialist based in Indianapolis,...Responsibilities: * Assist in the preparation and submission of pharmacy claims to third party insurance carriers.… more
    Robert Half Accountemps (10/25/24)
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  • Pharmacy Information Services…

    Medical Mutual of Ohio (OH)
    Pharmacy Benefit Manager (PBM) vendor for processing of pharmacy claims , accumulator transfers, performance guarantees, provisioning, and adjustments. . ... internal teams with processes specific to group billing of pharmacy claims processes, preparation of annual regulatory...prescription drug management (PBM) company. . Knowledge of PBM benefits set up, claims processing, and related… more
    Medical Mutual of Ohio (10/19/24)
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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 (09/26/24)
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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 Benefits Specialist

    Intermountain Health (Murray, UT)
    **Job Description:** The Pharmacy Benefits Specialist (Customer Service) is responsible for the day-to-day operations of SelectHealth's prescription ... for seven years in a row.** **Job Description** The Pharmacy Benefits Specialist (Customer Service)...One year combined experience in any of the following: medical/ pharmacy claims processing; health benefit more
    Intermountain Health (11/01/24)
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  • Pharmacy Program Specialist *Remote

    Providence (Beaverton, OR)
    … plans and the member care by providing our expertise in the application of pharmacy benefits management. This means that we have a phone center and prior ... Member Services.** **Providence Health Plan is calling a Pharmacy Program Specialist , Call Center who will:**...will:** + Be responsible for performance of technically detailed pharmacy and benefit work affecting pharmacy more
    Providence (11/04/24)
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  • Clinical Pharmacy Program Specialist

    Prime Therapeutics (Columbus, OH)
    …our passion and drives every decision we make. **Job Posting Title** Clinical Pharmacy Program Specialist - Remote **Job Description Summary** This position is ... quality programs. It requires extensive knowledge of medications, disease states, pharmacy sig codes, Centers for Medicare and Medicaid technical specifications and… more
    Prime Therapeutics (11/04/24)
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  • Pharmacy Business Specialist

    St. Luke's Health System (Boise, ID)
    …of colleagues, St. Luke's is truly a great place to work. We are seeking a Pharmacy Business Specialist to join our Pharmacy Administrative team. This is a ... **NEW** position created to support the pharmacy service line, which encompasses a wide range of...and HIPAA + Knowledge of reimbursement practice and electronic claims processing + Experience with EPIC Willow Ambulatory **What's… more
    St. Luke's Health System (08/29/24)
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  • Audit Specialist - Pharmacy

    BrightSpring Health Services (Englewood, CO)
    …+ Basic pharmacy knowledge of reading and interpreting prescriptions and submitting pharmacy claims to PBM payers. + Working knowledge of automated billing ... to all the Amerita locations, the PBM Payer Audit Specialist reviews audit request, compiles and classifies existing documentation...issues, or trends . * Medical, Dental & Vision Benefits plus, HSA & FSA Savings Accounts* Supplemental Coverage… more
    BrightSpring Health Services (10/08/24)
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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 (10/26/24)
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  • Pharmacy Program Specialist

    State of Montana (Helena, MT)
    …by the supervisor and must adhere to state policy. **Title:** * Pharmacy Program Specialist (11721)* **Location:** *Helena* **Requisition ID:** *24142768* ... the Healthy Montana Kids (HMK) Plan. As a Program Specialist , this position is responsible for duties related to...with the administrative rules, statutes, and policies concerning the claims payment system and coding; working with members and… more
    State of Montana (10/26/24)
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  • Pharmacy Networks Specialist I

    Centene Corporation (Sacramento, CA)
    …expert supporting various pharmacy operations tasks including but not limited to claims , formulary, benefit , and networks. + Serve as the subject matter ... /formulary setup and hierarchy based on plan specifics. + Provides analytic support related to pharmacy claims and trends. + Serve as the subject matter… more
    Centene Corporation (10/02/24)
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