- Prime Therapeutics (Austin, TX)
- …decision we make. **Job Posting Title** SIU Specialist - Pharmacy Tech - Remote in the California market **Job Description** Responsible for the intake and initial ... Education Level Bachelors + Experience Level 2+ years + Required Fraud Investigations and Claims experience Must be eligible to work in the United States without the… more
- Molina Healthcare (Dallas, TX)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... life cycle + Gains a deep understanding of Molina claims life cycle and all processes that affect ...claims life cycle and all processes that affect claims payment + Develops and maintain standards and best… more
- Actalent (Dallas, TX)
- Job Title: Remote Pharmacy Technician Job Description: As a Remote Pharmacy Technician, you will play a crucial role in managing coverage determination requests ... communication and interpersonal skills. + Ability to work independently in a remote setting. Preferred Qualifications: + Previous experience in a retail pharmacy… more
- Sedgwick (Dallas, TX)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Remote Housing Support Specialist ** REMOTE POSITION** **Schedule: MONDAY - FRIDAY ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- NTT DATA North America (Dallas, TX)
- NTT DATA, Inc. is currently seeking a Remote - Provider Data Management Processors to join our team. Our Client is one of leading Health Plans in US. ... experience in a Healthcare processing (Provider Data Management preferred, Claims , Credentialing, or other Healthcare Payer/ Provider experience) Preferred… more
- IQVIA (Houston, TX)
- …We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) contact **Care Navigator - Certified Biller and Certified Coder ... The **Care Navigator** is primarily responsible for receiving medical claims from HCPs or patients and vetting the claim...to be converted to an IQVIA full-time employee. \#LI-CES \#LI- Remote \#LI-DNP IQVIA is a leading global provider of… more
- Houston Methodist (Houston, TX)
- …and capture potential revenue opportunities. This position performs quality assurance, detailed claims analysis and medical record reviews of complex claims and ... FUNCTIONS** + Conducts risk-based and baseline reviews of complex and escalated claims or records in a timely manner, evaluates corrective actions and processes… more
- Molina Healthcare (Fort Worth, TX)
- …you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer partners ... Mastery * Track record coordinating cross-functional action plans with Enrollment, Claims , Pharmacy, Network, and Member Services * Hands-on experience maintaining… more
- Mass Markets (TX)
- …to resolve issues when needed + Accurately document and process customer claims in appropriate systems + Utilize knowledge base and training to accurately ... 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, Collections, Customer Experience Provider (CXP), Customer Service,… more
- Prime Therapeutics (Austin, TX)
- …every decision we make. **Job Posting Title** Member Campaign Program Analyst - Remote **Job Description** The Member Campaign Program Analyst is responsible for the ... + Pharmacy Benefit Management (PBM) experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Campaign management… more