- IQVIA (Houston, TX)
- **Patient Support Medical Claims Processing Representative ** _Contract Remote Role - Location (Open to Remote US)_ As the only global provider of commercial ... are looking for a 100% remote (work from home-WFH) contact **Patient Support Medical Claims Processing Representative ** to join our team. In this position, you… more
- Molina Healthcare (Houston, TX)
- 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 (Austin, TX)
- …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
- Molina Healthcare (Dallas, TX)
- …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
- Prime Therapeutics (Austin, TX)
- …experience, preferably leveraging AI + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + ... levels of leadership within the organization, acting as a representative of the broader Financial Systems team + Provide...we are a different kind of PBM. We're reimagining pharmacy solutions to provide the care we would want… more