- UPMC (Bridgeville, PA)
- UPMC Rx Partners is looking for a full time Pharmacy Clinical Review Specialist to join their dedicated team! This position provides prescription data entry and ... adjudication of claims under the supervision of a licensed pharmacist. This...supervision of a licensed pharmacist. This position provides customer service to Rx Partners Skilled nursing and Hospice clients.… more
- LA Care Health Plan (Los Angeles, CA)
- …additional service needs according to specific program guidelines. Uses claims processing and care management software to look up member information, document ... Care Management Specialist II, D-SNP Team (12 month Assignment) Job...predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health Homes Program (HHP) eligibility or other… more
- Molina Healthcare (Tampa, FL)
- JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to ... to ensure that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate appeals and… more
- TEKsystems (Woods Cross, UT)
- Billing Specialist - Healthcare Industry/Revenue Cycle Management Team - In Office Location: Woods Cross, UT (On-site) Schedule: Monday-Friday, 8-hour shifts ... About the Role We are seeking an experienced Billing Specialist to join a dynamic healthcare team and support...and timely claim submissions. Key Responsibilities + Submit approved claims and ensure proper acceptance. + Research, resolve, and… more
- Woodforest National Bank (The Woodlands, TX)
- …of one of the largest employee-owned banks in the country! The Dispute Specialist I is responsible for investigating and processing debit card and/or ACH dispute ... claims , and Stop Payments, initiated by customers or on...independently while supporting a team environment. . Strong customer service skills with the ability to effectively research and… more
- System One (Owings Mills, MD)
- Job Title: Customer Service Billing Specialist Type: 12+ month Contract Compensation: $24/HR Contractor Work Model: Hybrid- Owings Mills, MD ALTA IT Services is ... staffing a contractor for a Customer Service Billing Specialist to support a leading...years experience in a Billing, membership enrollment, member services, claims operations or Finance role. + Education Level: High… more
- BrightSpring Health Services (Gainesville, FL)
- …full understanding of the recruitment cycle to provide support to operations. The HR Specialist should partner with each service site to develop and implement a ... Onsite Position-will be working out of our Gainesville office space. The HR Specialist is responsible for providing support to operations for various human resources… more
- University of Washington (Seattle, WA)
- …the SOM's Office of Research and Graduate Education charged with providing multi- service support to clinical researchers bringing important new therapies to our ... with evolving regulatory requirements. **Position Purpose** **:** Clinical Research Billing Specialist position will enable the Clinical Research Billing Manager and… more
- University of Southern California (Newport Beach, CA)
- …ancillary services and/or chemotherapy and other infused treatments as needed in assigned service line. The Specialist will be instrumental in obtaining written ... The Clinical Authorization Specialist will take the lead in securing medical...behavior. Preferred Qualifications: + Pref Experience in area of service . + Pref Medical Prior Authorizations or Claims… more
- Trinity Health (Fort Wayne, IN)
- …Type:** Full time **Shift:** **Description:** The Specialty Pharmacy Revenue Cycle Specialist is responsible for performing the appropriate processes to obtain and ... the timeframe stated in the policy and procedure. Escalates service issues arising from prior authorization request or other...copays at the time of scheduling. Submit Medicare B claims Submit Major Medical claims (primary and… more