- Humana (Richmond, VA)
- …level by driving real impact and shaping the future of claims management? As a Senior Pharmacy Claims Professional , you will play a pivotal role in ... and take the lead on building solutions that make a difference! The Senior Pharmacy Claims Professional analyzes and answers inquiries regarding… more
- Humana (Richmond, VA)
- **Become a part of our caring community and help us put health first** The Senior Pharmacy Claims Professional adjudicates pharmacy claims and ... process pharmacy claims for payment. The Senior Pharmacy Claims Professional work assignments involve moderately complex to complex issues where… more
- Elevance Health (Richmond, VA)
- **Account Service Manager Sr - Pharmacy Account Management** **Location:** This position will work a hybrid model (remote and office). The ideal candidate must live ... plan design, researching and resolving phone and written inquiries, resolving claims , benefit and enrollment issues. + Presents monthly, ad hoc, mid-year,… more
- Elevance Health (Richmond, VA)
- …referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying ... **Investigator Senior ** **Supports the Payment Integrity line of business**...to recover corporate and client funds paid on fraudulent claims . **How will you make an impact:** + Claim… more
- Elevance Health (Richmond, VA)
- …referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying ... ** Senior Investigator (Investigator Sr)** _Location: This position will...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim… more
- Humana (Richmond, VA)
- …informaticists to define various clinical concepts and extract clinical information from medical, pharmacy , and lab claims for analytics and modeling purposes + ... + Healthcare or managed care working experience + Experience working with medical, pharmacy , lab claims + Experience working with big data and using… more
- Elevance Health (Richmond, VA)
- …referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for identifying and ... healthcare fraud in order to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding,… more