- Molina Healthcare (Buffalo, NY)
- JOB DESCRIPTION Job SummaryProvides customer service support for inbound/outbound pharmacy calls from members, providers, and pharmacies. Contributes to overarching ... pharmacy strategy for optimization of medication related health care... prior authorization requests and/or appeals. * Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any… 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
- 32BJ Benefit Funds (New York, NY)
- …Range: 54964.76 To 54964.76 (USD) Annually Job Title: Member Services Representative (Benefits Specialist) Department: Member Services The 32BJ Benefit Funds is ... SRSP, Shortman). + Handling of inquiries through vendors, Medical, Optical, Pharmacy , Dental and Employee Assistance. + Follow workflows to resolve participant… more
- Molina Healthcare (Bronx, 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
- Crouse Hospital (Syracuse, NY)
- …Crouse's Business Office team is hiring a full time Patient Account Representative . Pay Range: $19.75 - $33.32 / hour Schedule: Monday-Friday, 7:00am-3:30pm. Patient ... Account Representative Position Responsibilities: + Responsible for performing all essential...making phone calls to payers for status on unpaid claims . + Reviewing and analyzing all payer 835 files… 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
- KPH Healthcare Services, Inc. (Gouverneur, NY)
- …GED, or equivalent experience **Experience:** + Preferred: 0-2 years experience as a Pharmacy Technician or Customer Service Representative in a health care ... issues to ensure complete client satisfaction. + Provide Help Desk resolution of Pharmacy Network problems to ensure complete client satisfaction. + Assist with the… more