Pharmacy Reimbursement Specialist | Optimize Claims
Navitus
Navitus Health Solutions is seeking a Pharmacy Reimbursement Administrator to join our team. The PRA collaborates with Provider Relations, IT Client Operations, and others to review, monitor, and update procedures for efficient claims adjudication. The role includes testing networks, overseeing remittances and recoveries, and generating reports on reimbursement activities. Responsibilities include network pricing setup testing, data import/export, QA on network rates, and ensuring compliance #J-18808-Ljbffr Navitus
- ...entry-level role. What does a Medical Billing and Coding Specialist do? A medical billing and coding specialist processes and codes healthcare claims to ensure accurate billing and insurance reimbursement, supporting the financial operations of healthcare facilities...ReimbursementClaimsRemote work
$750 per month
...Lumicera Health Services is seeking a Reimbursement Specialist I to join our team! Under direction from the Assoc. Manager, Specialty Pharmacy Services, Reimbursement Team Lead, and... ...Responsible for ongoing monitoring of claims activity for accuracy and successful submission...ReimbursementClaimsTraineeshipRemote workFlexible hours- Lumicera Health Services seeks a Reimbursement Specialist I to join our team. Under direction from the Assoc. Manager, Specialty Pharmacy Services, Reimbursement Team Lead, and pharmacists... ...assistance reimbursements and monitor claims activity, ensuring accurate patient...ReimbursementClaimsRemote job
- Navitus Health Solutions is seeking an Analyst, Pharmacy Contract Audit to oversee contractual pharmacy network reimbursement accuracy and ensure compliance with Retail,... ...Order agreements. The role entails reviewing claims data, auditing network pricing, and creating procedures...ReimbursementClaimsRemote jobContract work
- ...of care, or purchasing. The role involves performing advanced pharmacy technician duties that require specialized knowledge and skills... ...audits of specialized area. Reports and monitors KPIs to ensure optimal performance. Identifies quality improvement opportunities based...SuggestedLocal areaShift workDay shift
$16 - $24 per hour
...accordance with Company policies and procedures by properly handling claims and returns zoning the area arranging and organizing... ...discounts, Military Leave Pay, adoption and surrogacy expense reimbursement, and more.Live Better U is a company paid education benefit program...ReimbursementClaimsHourly payMinimum wageFull timeTemporary workPart timeShift work- ...transparent, auditable insights in milliseconds across real-time claims workflows. Lyric augments human decision-making so health... ...solutions that enable fast, accurate, and intelligent coverage and reimbursement decisions. Serving as a key voice for clinical content and...ReimbursementClaimsFull timeRemote workVisa sponsorship
$79.7k - $105.48k
...Urology services and requires advanced knowledge of CPT, HCPCS, ICD-10-CM, reimbursement methodologies, and healthcare compliance regulations. The Compliance Auditor performs detailed claim reviews, identifies coding and documentation risks, analyzes trends, develops...ReimbursementClaimsFull timeTemporary workLocal areaImmediate startRemote workFlexible hours$17 - $25 per hour
...accordance with Company policies and procedures by properly handling claims and returns; zoning the area; receiving and stocking... ...discounts, Military Leave Pay, adoption and surrogacy expense reimbursement, and more.Live Better U is a company paid education benefit program...ReimbursementClaimsHourly payMinimum wageFull timeTemporary workPart timeShift work$53.5k - $86.4k
...investigating and confirming the facts of loss for complex Homeowner's Claims. Determines coverage, damages and otherwise adjusts and... ...to work from home also receive a monthly connectivity reimbursement to help offset internet costs. When working from home, you must...ReimbursementClaimsContract workWork at officeWork from homeVisa sponsorshipWork visaRelocation package$169k - $213.8k
Build our future together:The Field Reimbursement Manager is a critical front-line member of... ...colleagues (ex. Regional Directors and Medical Specialists) to educate physician offices in... ...working with billing and medical claims personnel in various health care settings...ReimbursementClaimsFull timeWork at officeRemote work$750 per month
Overview Navitus Health Solutions is seeking a Pharmacy Reimbursement Administrator to join our team! The Pharmacy Reimbursement Administrator... ..., monitor, and update procedures to improve efficiencies of claims adjudication administration. The PRA will test and review pharmacy...ReimbursementClaimsContract workFlexible hours$750 per month
...Due to growth, we are adding a Analyst, Pharmacy Contract Audit to our team! The Analyst... ...of Navitus’ contractual pharmacy network reimbursement accuracy. The individual in this... ...Analyst will continually review and monitor claims data, create, and update procedures, audit...ReimbursementClaimsContract workRemote workFlexible hours$19 - $27 per hour
...merchandised according to company policies, including proper handling of claims, returns, shrink, and damages. Presents and maintains... ...discounts, Military Leave Pay, adoption and surrogacy expense reimbursement, and more. Live Better U is a company paid education...ReimbursementClaimsHourly payMinimum wageFull timeTemporary workPart timeShift work$26 - $51 per hour
...tracking orders. Records purchases and usage. Submits warranty claims. Complies with Occupational Safety and Health Administration... ...discounts, Military Leave Pay, adoption and surrogacy expense reimbursement, and more. You will also receive PTO and/or PPTO that can be used...ReimbursementClaimsHourly payMinimum wageFull timeContract workTemporary workPart timeFor contractorsWork experience placementLocal area$71.1k - $97.8k
...factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home,...ReimbursementClaimsBi-weekly payFull timeContract workTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday$43.89k - $93.57k
...The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance... ...knowledge, including new changes to coding compliance and reimbursement. Required Qualifications AAPC CPC certification Minimum of...ReimbursementClaimsHourly payFull timeTemporary workLocal area$100k
...Responsibilities: inspect roofs and document damage, educate homeowners in plain language, meet insurance adjusters on site and work claims, and manage the customer relationship from first inspection through the finished roof. Requirements: no experience necessary;...Claims- ...Job Description Job Description Benefits: ~ License Reimbursement ~401(k) matching ~ Bonus based on performance ~ Competitive... ...customers with policy changes and inquiries. Process insurance claims and follow up with customers on claim status. Coordinate...ReimbursementClaimsWork at officeLocal areaFlexible hours
- ...Serves as a resource to other healthcare professionals including pharmacy students and residents and ensures that patient care meets... ...medication dispensing process to ensure accurate and timely delivery of optimal pharmacotherapy to patients. This includes supervision of...Hourly payWeekly payLocal areaFlexible hoursShift work
- ...other healthcare professionals including pharmacy students and residents and ensures that... ...ensure accurate and timely delivery of optimal pharmacotherapy to patients. This... ...FlexPath Funded Traditional tuition reimbursement and professional development opportunities...ReliefLocal areaFlexible hoursShift work
- ...center for St. Louis office-based team membersGym membership reimbursement for project-based team membersCorporate office cafeteria accessEmployee... ...performed by the Vice President.Researches potential project claims. Recommends to the VP how to handle the situation. Develops a...ReimbursementClaimsFull timeContract workFor contractorsFor subcontractorWork at office
- A leading insurance adjusting firm in Missouri is seeking Independent Insurance Claims Adjusters to join their team. This role offers the chance to help people recover from disasters while benefiting from comprehensive training and support. Candidates should be licensed...ClaimsFlexible hours
- ...this role is on strategic planning and optimization of UM processes. The Medical Director will... ...providers, appeals team, medical and pharmacy consultants for reviewing complex cases... ...utilization and health care quality. Reviews claims involving complex, controversial, or...ClaimsFull timeRemote workWeekend work
- ...ensure the accuracy of DRG assignment and reimbursement. Requires advanced expertise in ICD-10-... ...expertise. ~ Evaluates claims and medical records for compliance with... ...Administrator required or: CCS-Certified Coding Specialist required or: Certified International...ReimbursementClaimsFull timeH1bRemote work
- ...trusted name in the industry, we are proud to foster a culture of excellence and continuous learning. What You’ll Do: As a Claims Specialist (or Senior Claims Specialist, based on experience) , you will play a vital role in our fast-paced Claims Department by handling...ClaimsWork at office
$216.06k - $293.09k
...patient’s care is fully covered — no dealing with insurance or reimbursement Responsibilities: Diagnose and treat a full spectrum... ...care, and collaborate with multidisciplinary teams to optimize the health and readiness of service members across hospital,...ReimbursementFull time- IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth...Claims
$52k - $60k
...Account Representative Act as a conduit between clients, who bill medical insurance claims electronically, and Quadax. The Account Representative is the face of Quadax and interacts with both clients (hospitals and physician practices) and Quadax personnel alike. This...ClaimsRemote work- ...offering ongoing support and guidance, particularly during the claims process, to ensure client satisfaction. What We're Looking... ...and able to obtain Health & Life producer license - licensing reimbursement offered) Bachelor's degree or a minimum of 10 years of professional...ReimbursementClaimsWeekly payWork experience placementLocal area
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