- Independent Health (Buffalo, NY)
- …a daily basis. Assist in interpreting database information as it relates to pharmacy claims processing. + Assist with PBM implementation by identifying potential ... systems department with various data entry projects/information as they relate to pharmacy claims processing. C. Administrative Duties + Provide accurate and… more
- University of Rochester (Rochester, NY)
- …the individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE: The Pharmacy Access Representative III (PAR) is responsible for the ... other related duties as required, including work relating to the Intake Pharmacy Access Representative **Prior Authorization Management** + Maintains expertise… more
- Highmark Health (Albany, NY)
- …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
- Independent Health (Buffalo, NY)
- …a passion for service, and practices empathetic listening towards all Pharmacy Benefit Dimensions (PBD) customers. The Servicing Representative functions ... a culture that fosters growth, innovation and collaboration. **Overview** The Servicing Representative is a customer service professional who displays confidence,… more
- Independent Health (Buffalo, NY)
- …and 5pm** **Monday through Friday** . **Overview** The Provider Relations Representative will be responsible for assisting our provider constituents and providing ... exceptional customer service. The Provider Relations Representative will answer incoming calls from health care providers including physician offices, ancillary… more
- Molina Healthcare (Buffalo, NY)
- …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 (Ramapo, NY)
- …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
- CVS Health (Albany, NY)
- …as well as navigating them through the health system, providing support on claims issues, and answering coverage-level questions. **We have two of these roles to ... any benefits related issues including answering routine questions, addressing denied claims , preauthorization, and providing support to both the employees and the… more
- Community Wellness Partners (Oswego, NY)
- …in accordance with established policies and procedures. + Interview sales representative and select vendors/suppliers in accordance with established policies and ... and implement recommendations from the facility's committees, eg Quality Assurance, Pharmacy , Infection Control, etc. + Check invoices, purchase orders, packing… more
- Independent Health (Buffalo, NY)
- …standards in the following categories as measured and recorded in the representative 's scorecard. + Log all contacts into appropriate systems. + Technical ... appeals as needed. + Effectively resolve inquiries from customers regarding claims , benefits, eligibility, and reimbursement. + Maintain knowledge of all pertinent… more