Average salary: $65,793 /yearly
More stats ...arrangements.
Research, identify and organize requested audit documentation in timely manner.
Perform prescription claims adjudication including communication with insurance companies regarding rejected claims, eligibility, prior authorizations or other issues as...
Suggested
Hourly pay
Full time
Temporary work
Flexible hours
...employees/managers with information and assistance regarding potential leaves
- Produce and track all required documentation
- Assess, adjudicate, and track all FMLA claims and available time
- Coordinate leaves with Short Term Disability Vendor and Workers’ Compensation...
Suggested
Full time
Temporary work
Local area
...calculations including basic mathematical calculations (e.g., converting milligrams)
+ May resolve issues of denials identified through adjudication, and follow-up claims in Point of Sale (POS)
+ Maintains current knowledge of Medicaid claim regulations and processes
+ May...
Suggested
Full time
Flexible hours
Shift work
...oversight when responding to higher level inquiries or obtaining necessary information or evidence to ensure pending claims are properly adjudicated.
Maintains effective labor/management relationships and accomplishing personnel management duties in accordance with...
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Permanent employment
Full time
Temporary work
Part time
Work experience placement
Local area
Remote job
Monday to Friday
...is responsible for the interpretation and data entry of basic prescriptions, prior authorization processing, and troubleshooting adjudication issues.
Primary duties include, but are not limited to:
Verify member information and input data for the pharmacists....
Suggested
Holiday work
Temporary work
Local area
Remote job
Monday to Friday
...is responsible for the interpretation and data entry of basic prescriptions, prior authorization processing, and troubleshooting adjudication issues.
Primary duties include, but are not limited to:
Verify member information and input data for the pharmacists....
Suggested
Holiday work
Temporary work
Local area
Remote job
Monday to Friday
...is responsible for the interpretation and data entry of basic prescriptions, prior authorization processing, and troubleshooting adjudication issues.
How You Will Make an Impact
Primary duties may include, but are not limited to:
Verify member information and...
Suggested
Holiday work
Full time
Temporary work
Local area
Remote job
Work from home
Shift work
Monday to Friday
...Random Drug Testing required.
* Security Requirement: Non-Critical Sensitive (2). This position requires completion and favorable adjudication of a background investigation prior to appointment, unless a waiver is obtained. Subject to a 5 year period reinvestigation.
*...
Suggested
Full time
Part time
Remote job
...requests for RA are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments, based on your...
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Holiday work
Permanent employment
Full time
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Part time
For contractors
Internship
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Relocation
Felony friendly
Flexible hours
...judgement
- Provide a stellar customer experience while accurately and efficiently completing all steps of reception, data entry, adjudication, and product dispensing
- Understand and follow the company guidelines on the operation of the cash register and follow all...
Suggested
Permanent employment
Part time
Local area
...reconciliation, whether processed or pended, as well as recovered in error.
Associate must identify the correct formulas in order to adjudicates impacted claims, using multiple COB Formulas for the various product types, pursuant to State and Federal Guidelines.
Minimum...
Suggested
Holiday work
Full time
Temporary work
Work experience placement
Local area
Remote job
Monday to Friday
...history to reconcile processed, pended or recovered in any error.
Associate must identify the correct formulas in order to adjudicates impacted claims, using multiple COB Formulas for the various product types, pursuant to State and Federal Guidelines.
Minimum...
Suggested
Holiday work
Full time
Temporary work
Work experience placement
Local area
Remote job
Monday to Friday
...delivery of the program; and the vendor's backroom personnel all necessary to support the data collection, approval, deliveyr, and adjudication of civil penalties associated with the program. The incumbent shall serve as a deputy to the WSCS Program Director, upon request...
Suggested
Holiday work
Full time
Work experience placement
Remote job
Flexible hours
...subject to the completion of a favorable suitability or fitness determination, where reciprocity cannot be applied; unfavorably adjudicated background checks will be grounds for removal.
Selective Service Requirement: Males born after 12-31-59 must be registered or...
Suggested
Permanent employment
Full time
Contract work
Temporary work
Part time
For contractors
For subcontractor
Internship
Trial period
Flexible hours
...subject to the completion of a favorable suitability or fitness determination, where reciprocity cannot be applied; unfavorably adjudicated background checks will be grounds for removal.
Selective Service Requirement: Males born after 12-31-59 must be registered or...
Suggested
Holiday work
Permanent employment
Full time
Contract work
Temporary work
Part time
For contractors
Overseas
Trial period
Flexible hours
Weekend work
Afternoon shift
...requests for proposals (RFP).
Research claim disputes and eligibility and work with carriers to ensure claims are properly adjudicated.
Work with GMIS in testing and communicating system upgrades and changes.
Coordinate program elements with other SPD Divisions...
Remote job
Holiday work
Full time
Temporary work
Work experience placement
Flexible hours
...billing and collection procedures as outlined in policies and provides payers with the appropriate and necessary information to adjudicate claim
• Maintains A/R to meet Network set goals
• Meets productivity standards designated by the department
• Meets...
Full time
Work from home
...Department Head
Mission
Support the materials acquisition management, providing product and software expertise and product adjudication function across 3 business units.
The duties and functions of this position are to manage the process of acquiring materials...
Holiday work
Rotating shift
Day shift
Saturday
Monday to Friday
...is responsible for the interpretation and data entry of basic prescriptions, prior authorization processing, and troubleshooting adjudication issues.
Primary duties include, but are not limited to:
Verify member information and input data for the pharmacists....
Holiday work
Full time
Temporary work
Local area
Remote job
Monday to Friday