LTC Pharmacy Claims Specialist: Adjudication & Overrides
CommuniCare Health
CommuniCare Health is hiring a Pharmacy Claims Specialist in Maryland. The role focuses on adjudicating unit dose and non-unit dose claims, contacting insurers for overrides, and onboarding new admits with proper payment methods. Responsibilities include processing new admit reports, maintaining Welcome Packets, and ensuring timely ECM billing documentation. The position requires coordinating with facilities, families, and billing teams to keep batches, notes, and medication lists up to date. #J-18808-Ljbffr CommuniCare Health
- ## Pharmacy Claims SpecialistApplylocations: Pharmacy Solutions Group - Marylandtime type: Full timeposted on:... ...DrSuites K-MGlen Burnie, MD 21061**Pharmacy Claims Specialist** **Responsibilities:**Responsible for adjudication of daily unit dose and non-unit dose claims*...SuggestedDaily paidTemporary work
- ...Pharmacy Billing Specialist Reports to: Pharmacy Billing Supervisor Job Type: Full-Time Hybrid/Remote Pharmacies: West Virginia, Ohio, Indiana... ...a plus (but not required) Knowledge of Framework LTC a plus (but not required) Salary and Benefits: Competitive...SuggestedFull timeWork at officeRemote work
- CommuniCare Health is seeking a Pharmacy Billing Specialist based in Glen Burnie, MD, to manage and update patient accounts ensuring consistent billing processes across various payers. This full-time hybrid/remote role involves collaboration with facility business office...SuggestedRemote jobFull timeWork at office
$69.4k - $99k
...Columbia;US-MD-Ellicott City;US-MD-Catonsville Job Category Claims and Investigation Position Type Regular Full Time Req ID... ...Join our team as a Property Field Inspection Claim Specialist and showcase your expertise in handling accident and weather-related...SuggestedFull timeWork experience placementInternshipWork at officeLocal areaRemote workWork from homeFlexible hours$102.61k - $197k
...quality and service improvement teams. Minimal Qualifications Education Doctoral degree PharmD from an accredited college of Pharmacy required or an equivalent Pharmacy degree from an accredited college of Pharmacy required Experience ~1-2 years of direct...SuggestedRelief$20.53 - $33.9 per hour
...among our team members. We also collaborate with doctors, nurses and specialists throughout Johns Hopkins Medicine to ensure continuity of your care. Join our dynamic team as an Outpatient Pharmacy Technician, where you'll play a vital role in ensuring the smooth operation...Full timeRemote work$61.78 - $101.96 per hour
...Report. Take a tour of our campus : The Department of Pharmacy, consistent with the mission of Johns Hopkins Medicine, places... ...there are over 85 acute care and primary care clinical pharmacy specialists as well as 32 general and specialized pharmacy residents....Full time$50.63 - $89.1 per hour
...Specialty Pharmacist Under the supervision of the specialty pharmacy manager, facilitates the safe, effective, and economically... ...Mastery of medication prior authorization process and insurance adjudication Ability to enter data in various computer applications in a...Work at officeLocal area$57.87 - $92.4 per hour
...other locations in 13 counties. For more information, visit Job Summary Provide comprehensive medication therapy management and pharmacy services to ensure safe, effective, and cost-efficient patient care. Collaborate with interdisciplinary teams, oversee medication...Work experience placementRelief$55.25 - $84.75 per hour
...Baltimore, Maryland works at the center of in-patient interdisciplinary care, collaborating directly with prescribers and mentoring pharmacy support staff within a 483-bed hospital setting that provides a full range of medical, surgical, and specialty services....Full timePart timeWork at officeFlexible hours$68 per hour
...Hospital in Baltimore, Maryland works at the center of interdisciplinary care, collaborating directly with prescribers and mentoring pharmacy support staff within the in-patient hospital setting. Why Pharmacists Choose LifeBridge Health Pharmacy clinical career...Daily paidReliefWork at officeFlexible hours- ...Clinical Pharmacy Specialist I Responsible for providing medication therapy management services, both clinical and distributive tasks as necessary, in collaboration with other providers to assure that drug therapy is safe, effective, efficient and cost-effective; pharmacy...
- ...Clinical Pharmacy Specialist The Clinical Pharmacy Specialist provides pharmaceutical care services through direct interaction with patients and clinicians, at the highest level of clinical practice, working in close collaboration with other clinical team members and...Work at office
- ...Property Liability Adjuster will manage all aspects of liability claims in the Washington DC/Baltimore market. The field‑based... ...adjuster license required. Fundamental understanding of claims adjudication and basic knowledge of commercial/residential construction, automotive...Contract workFor contractors
$62.13 - $93.19 per hour
...Clinical Pharmacy Specialist - PRN - AAMC Responsible for carrying out Clinical Pharmacy services through promoting evidence-based pharmacotherapy and sound pharmaceutical care through the development of medication management protocols, and drug therapy policies. Serves...Relief$103.12k - $177.88k
National Account Strategic Underwriter Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured...Contract workTemporary workWork experience placementWork at officeLocal area2 days per week1 day per week- ...high-level administrative support. The role includes managing patient appointments, maintaining confidentiality, and assisting with pharmacy operations. The ideal candidate has a High School Diploma or equivalent, with 3 years' experience preferred. Skills in medical...Work at office
$59.29 - $97.91 per hour
Job Summary The Oncology Clinical Pharmacy Specialist in Acute Care Medical Oncology will provide pharmacotherapy oversight for adult patients with solid tumor malignancies in an acute care setting. Responsibilities include rounding with a multidisciplinary team, assisting...Local area- ..., and oversee medication distribution. You will collaborate with interdisciplinary teams, educate patients and staff, and support Pharmacy Leadership while maintaining regulatory compliance. A PharmD and Maryland license are required. #J-18808-Ljbffr University of Maryland...
- ...Claims And Program Representative As a Claims and Program Representative, you will: Handle calls through the Nationwide Toll-Free Service... ...Examine evidence and evaluates its validity and acceptability. Adjudicate claims for benefits and make entitlement decisions. Compute and...Work at officeLocal area
- ...earn commissions in excess of 140% of sales! We have an unmatched and proven hiring and onboarding system in place. Great carrier overrides and bonuses! Job requirements Life insurance license or willing to obtain one. You will need a valid driver's license and vehicle...Full timePart timeRemote workHome officeFlexible hours
- ...Claims Processor, Claims I Ampcus Inc. is a certified global provider of a broad range of technology and business consulting services... ..., MD. (Remote) Purpose: Under direct supervision, reviews and adjudicates paper/electronic claims. Determines proper handling and...Remote work
$60.23k - $84.33k
...Work® Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Workers Compensation | Jurisdiction: FL | Licensing... ...clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices...Remote workFlexible hours$51.81k - $83.55k
A leading risk management firm is seeking a Claims Specialist to manage lower-level workers’ compensation claims under supervision. The role requires excellent communication skills and the ability to analyze and solve problems. Candidates should have a bachelor's degree...- Job Description Are you an experienced Claims Examiner looking for a new opportunity with a prestigious healthcare company? Do you... ...procedures. Adheres to state and federal policies and procedures when adjudicating claims, including but not limited to, interest calculation and...Permanent employmentTemporary workShift work
- Mobilitas, a remote-first commercial insurance company created by CSAA Insurance Group, is seeking a Claims Specialist, Commercial Casualty to resolve all 1st and 3rd party injury claims across multiple regions with minimal supervision in a remote setting across the United...Remote job
$51.81k - $83.55k
The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within... ...full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account...Minimum wageFull timeLocal areaFlexible hours- Our client is seeking a Senior Commercial General Liability Claims Specialist to handle moderate-to-complex GCL claims across the East Coast. Responsibilities include coverage analysis, investigation, evaluation, negotiation and settlement of assigned claims. Key duties...Remote job
$17.34 - $21.34 per hour
...Claims Processor Pay Range: $17.34hr - $21.34hr The Claims Processor is responsible for examining, researching, and resolving non-adjudicated claims to ensure accurate and timely processing in accordance with medical policies, contracts, and procedures. The role...Remote job$51.8k - $75k
...ONE80 INTERMEDIARIES INC is seeking a Claims Accountant in Maryland responsible for managing and analyzing financial transactions related to insurance claims. The role ensures accuracy in claims payments and reporting while complying with regulatory requirements. The...
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