• Daiichi Sankyo, Inc. (Bernards, NJ)
    …contracts, trade/distribution agreements, as well as contracting relative to specialty pharmacy and patient support services. Provide advice and guidance on issues ... Serve as a member of Labeling and Pricing Committees and as legal representative on the promotional materials review team for market access team and materials… more
    HireLifeScience (11/02/24)
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  • Pharmacy Claims

    Humana (Columbus, OH)
    **Become a part of our caring community and help us put health first** The Pharmacy Claims Representative assists local pharmacies with claims ... up and maintaining hospice/facility/ pharmacy relationships under the direction of the Pharmacy Claims Team Leaders & the Pharmacy Claims (Support… more
    Humana (01/15/25)
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  • Experienced Patient Support Medical/Biller…

    IQVIA (Phoenix, AZ)
    **Experienced Patient Support Medical Claims Processing ​ Representative ** _Contract Remote Role - Location (Open to Remote US)_ As the only global provider of ... are looking for a 100% remote (work from home-WFH) contact **Patient Support Medical Claims Processing Representative ** to join our team. In this position, you… more
    IQVIA (12/21/24)
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  • Pharmacy Care Representative

    Apex Health Solutions (Houston, TX)
    Position Summary: The Pharmacy Care Representative performs duties to support the efforts of the pharmacy operations and solutions department in the ... health plan's pharmacy benefits and services. The Pharmacy Care Representative is primarily responsible for...NCQA guidelines, and CMS standards. Explains Point of Sale claims adjudication, state, NCQA, and CMS policy/guidelines, and any… more
    Apex Health Solutions (01/14/25)
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  • Pharmacy Customer Service/Billing…

    PruittHealth (Norcross, GA)
    **Billing, Collections and Posting Professional** Pruitt Health Home Infusion pharmacy is looking for an experienced and motivated Billing, Collections and Posting ... QA to insure accurate and timely creation of new claims and insures submitted claims meet payer...staff. **Collections** Strong skills and knowledge in home infusion pharmacy collections and timely follow ups with insurance companies… more
    PruittHealth (01/16/25)
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  • Customer Service Representative , Medicare…

    Molina Healthcare (Columbus, OH)
    **JOB DESCRIPTION** **Job Summary** Molina Pharmacy Services/Management staff work to ensure that Molina members, providers, and pharmacies have access to all ... These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal and state laws. Jobs… more
    Molina Healthcare (01/13/25)
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  • Clinical Pharmacy Manager - World Trade…

    Mount Sinai Health System (New York, NY)
    …the WTCH clinic population. The Clinical Pharmacy Manager will act as the pharmacy representative for the WTCHP clinic(s) in coordination with other MSHS ... prescription portal for QA report and analyzing + Reviewing pharmacy claims to identify outliers, utilization and...supervisor, subject to reasonable accommodation . + Serve as pharmacy representative on behalf of MSHP as… more
    Mount Sinai Health System (11/07/24)
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  • Byram Healthcare, Pharmacy Technician

    Owens & Minor (Salt Lake City, UT)
    …and/or Experience: High school diploma or equivalent; Experience in Third Party Claims processing; Knowledge in pharmacy operations and products utilized by ... opportunities to grow your career with a global company Description: Licensed Pharmacy Technician works under the supervision of a pharmacist and is responsible… more
    Owens & Minor (01/10/25)
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  • Pharmacy Coordinator

    Highmark Health (Harrisburg, PA)
    …coordination of benefit billing practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + ... **Minimum** + High school diploma or GED + Experience in pharmacy prescription claims processing/submission/payment. **Preferred** + Associate degree +… more
    Highmark Health (12/19/24)
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  • Pharmacy Technician, IPU

    Humana (Harrisburg, PA)
    **Become a part of our caring community and help us put health first** The Consultative Pharmacy Technician 3 is a Pharmacy Technician who acts as an intake for ... all calls from patients, pharmacies and providers. The Consultative Pharmacy Technician 3 performs advanced administrative/operational/customer support duties that… more
    Humana (01/10/25)
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  • Certified Pharmacy Technician

    Priority Health Care (Gretna, LA)
    …prescribed drug therapy is followed as prescribed and coordinate patients prescribed pharmacy care with their healthcare providers to ensure that drug therapy is ... (PIC) of stock needs and shortages. + Process Medicare, Medicaid, and Insurance claims . + Must have working knowledge of pharmaceutical calculations. + Able to add,… more
    Priority Health Care (12/27/24)
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  • Pharmacy Technician

    SpartanNash (Mancelona, MI)
    …service, utilizing the computer systems to maintain patient profiles and insurance claims , and checking out patients that ensures that the shift contributes to ... take inventory of medications (prescription and over the counter). + Notify Pharmacy Manager of supplies/products that need to be ordered. + Receive… more
    SpartanNash (01/15/25)
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  • Billing Representative

    Specialty Rx, Inc. (Ridgefield Park, NJ)
    …NYM when necessary. + Follow up and resolved pending billing issues. Billing Pharmacy Representative Requirements: + HS diploma or equivalent. + Courteous and ... Job Description SpecialtyRx is a full-service pharmacy . We need Billing Representative with...environment is a must. + Experience in New York Pharmacy billing claims . (Preferred) + Frameworks/ECM knowledge… more
    Specialty Rx, Inc. (01/09/25)
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  • Medicare D Billing Representative

    BrightSpring Health Services (Arlington, TX)
    …obtaining information completing necessary documentation or following up on outstanding claims + Individual with an understanding of Insurance and Medicaid ... needed to obtain approvals + Works with Client Billing Service Offices, Pharmacy Directors, customers and prescription drug plans to effectively communicate and… more
    BrightSpring Health Services (12/24/24)
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  • Account Service Representative

    Access Dubuque (Dubuque, IA)
    Account Service Representative **Kunkel & Associates, Inc.** 1 Positions ID: 59429 Posted On 01/07/2025 **Job Overview** Account Service Representatives are ... comp policies + Audit new/renewal monthly reports set up by Customer Service Representative to ensure accuracy + Review motor vehicle records + Prepare mid-year… more
    Access Dubuque (01/09/25)
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  • Customer Service Representative

    Independent Health (Buffalo, NY)
    …and paid time off (PTO), including company paid holidays. The Customer Service Representative position offers an opportunity to begin a career at Independent Health. ... the department and our family of companies. **Overview** The Customer Service Representative (CSR) is responsible for displaying confidence, passion for service, and… more
    Independent Health (11/15/24)
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  • Senior Customer Service Representative

    KPH Healthcare Services, Inc. (Gouverneur, NY)
    …tasks; ID card production, DMR's, creation of mass mailings to membership or resolving claims not adjudicated in the mail order platform. May possess alarm code and ... issues to insure complete client satisfaction. + Provide Help Desk resolution of Pharmacy Network problems to insure complete client satisfaction. + Assist with the… more
    KPH Healthcare Services, Inc. (12/12/24)
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  • Billing Representative

    Specialty Rx, Inc. (Orlando, FL)
    … + Experience in Long Term Care Pharmacy preferred + Experience in New York Pharmacy billing claims preferred + Must be able to work independently and as a ... Job Description Our Company SpecialtyRx is a Long-Term Care pharmacy providing pharmaceutical services to long term care facilities and assisted living communities.… more
    Specialty Rx, Inc. (11/13/24)
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  • Senior Provider Relations Representative

    Molina Healthcare (Gulfport, MS)
    …or exceed the Plan's monthly site visit goals. A key responsibility of the Representative during these visits is to proactively engage with the provider and staff to ... as they arise, making an assessment when escalation to a Senior Representative , Supervisor, or another Molina department is needed. Takes initiative in preventing… more
    Molina Healthcare (12/29/24)
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  • Customer Care Representative I

    Elevance Health (Mason, OH)
    …new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care. The **Customer Care Representative I** is responsible for ... **Customer Care Representative I** **Location:** This is a hybrid position...written correspondence regarding insurance benefits, provider contracts, eligibility and claims . + Analyzes problems and provides information/solutions. + Operates… more
    Elevance Health (12/25/24)
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