- Highmark Health (Jefferson City, MO)
- …requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and ... ensures effective and efficient delivery of Pharmacy call center services. Serves as first line reviewer in monitoring and ensuring adherence to the health plan's… more
- Norstella (Jefferson City, MO)
- …by querying and analyzing a wide range of healthcare data sources, including claims , lab results, electronic medical records (EMR), and other real-world data ... Norstella's unified Real World Data asset, a combination of claims , lab, SDOH and EMR data. You will be...Principles for success at Norstella:** 01: Bold, Passionate, and Mission- First 02: Integrity, Truth, and Reality 03: Kindness, Empathy,… more
- Norstella (Jefferson City, MO)
- …offerings leveraging Norstella's unified Real World Data asset, NorstellaLinQ, a combination of claims , lab, SDOH and EMR data. You will be joining an organization ... accuracy and quality. * Perform in-depth analyses on healthcare data sources, including claims , lab, EMR/EHR, and SDOH data, to uncover actionable insights and drive… more
- Walmart (Maplewood, MO)
- …assisting the pharmacist in the prescription fulfillment process processing third party insurance claims andor rejections assisting patientsmembers with ... area in accordance with company policies and procedures by properly handling claims and returns utilizing equipment to perform a variety of merchandising functions… more
- RxBenefits (Kansas City, MO)
- …the highest impact externally. + Validate differing types of datasets from dozens of medical vendors and dozens of PBMs to ensure it meets the requirements for our ... and drug utilization. + Be the SME on dozens of medical vendor/PBM contracts including utilization rules, B/G classification, discount applicability, rebate/fee… more
- Mass Markets (MO)
- …this role, you will make outbound phone calls on behalf of the Republican party to encourage people to vote in the 2020 presidential election. Candidates should be ... comfortable calling on behalf of the Republican party and have excellent communication skills, willing to learn...account management tasks + Accurately document and process customer claims in appropriate systems + Follow all required scripts,… more
- BJC HealthCare (St. Louis, MO)
- …Accounts Analyst who will be appeals and follow up on denials on hospital claims and following up on government payors. **Overview** **BJC HealthCare** is one of the ... care and other financial assistance to patients to ensure medical care regardless of their ability to pay. In...arrangements and hospital agreements. + Monitors reimbursements from third party carriers as defined in contracts through federal and… more
- Otsuka America Pharmaceutical Inc. (Jefferson City, MO)
- …this deep-rooted dedication that drives us to uncover answers to complex, underserved medical needs, so that patients can push past the limitations of their disease ... and execution. + Prior experience in field leadership roles such as first - or second-line leadership, regional operational and customer strategy roles or other… more
- Otsuka America Pharmaceutical Inc. (Jefferson City, MO)
- …pharmaceutical experience + Prior experience in field leadership roles such as first or second line leadership, regional operational and customer strategy roles or ... a minimum of 5 business days. **Company benefits:** Comprehensive medical , dental, vision, prescription drug coverage, company provided basic...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- HCA Healthcare (Kansas City, MO)
- …in you as a Coding Account Resolution Specialist-Inpatient? At Parallon, you come first . HCA Healthcare has committed up to $300 million in programs to support ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more