- MyFlorida (Miami, FL)
- …. Requisition No: 862120 Agency: Department of Health Working Title: OPS MEDICAL DISABILITY EXAMINER - ... Date: 12/21/2025 Total Compensation Estimator Tool (https://compcalculator.myflorida.com/) DEPARTMENT OF HEALTH DIVISION OF DISABILITY DETERMINATIONS OPEN COMPETITIVE OPPORTUNITY POSSIBLE… more
- Ascension Health (Austin, TX)
- …$18.75 - $25.13 / per hour **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans ... support for the pharmacist. + Provide accurate data entry, prescription processing , and technical support for the pharmacist within the remote home-delivery… more
- The Cigna Group (Morris Plains, NJ)
- …of: IBM Mainframes; COBOL6; JCL; VSAM; DB2; MQ; TSO/ISPF; PBM claim adjudication processing ; Inflation Reduction Act ("IRA"); CMS (HIPPA); NCPDP guidelines; ... Point of Sale; Coordination of Benefit ("COB"); manual submitted claims processing ; retail pharmacy network system; CA-7...of benefits, with a focus on supporting your whole health . Starting on day one of your employment, you'll… more
- Centene Corporation (Queens, NY)
- …implementation and optimization of health plan operations systems (eg, claims adjudication platforms, CRM tools). + Drive digital transformation initiatives ... Centene is transforming the health of our communities one person at a...related to operational areas. + Oversee day-to-day operations including claims processing , provider network management, member services,… more
- MyFlorida (Miami, FL)
- …but are not limited to fraud against the Medicaid Program, false claims against the Medicaid program, investigating possible criminal violations of any applicable ... patients, investigate the alleged misappropriation of patients private funds in health care facilities. This is independent work conducting investigations of alleged… more
- Aston Carter (Salem, OR)
- …data manipulation and use of data analysis tools. + In-depth understanding of claims processing , clinical edits, fee schedules, and payer contracts. + Proficient ... improvement projects within a medical coding environment. + Understanding of EHR, Claims Adjudication Systems, Revenue Cycle concepts, and data mining tools.… more
- Molina Healthcare (OH)
- …+ Experience working in a Medicare environment is highly preferred. + Claims adjudication experience is highly preferred. **Job Qualifications** **Required ... encounter processes, provider and contract configuration, provider information management, claims processing and other related functions. **Preferred Education**… more
- UPMC (Pittsburgh, PA)
- …Technician, Intermediate provides pharmaceutical care to patients within the UPMC Health System by showing proficiency in essential technician functions like sterile ... Technician, Intermediate services are provided in compliance with Department of Health , The Joint Commission, and State Board of Pharmacy regulations.… more
- Insight Global (Tukwila, WA)
- …2 years' Experience in health care or pharmacy billing, collections, or medical claims processing * 2 years' Experience as a pharmacy technician in a ... Providence Infusion and Pharmacy Services business lines. * Responsibility also entails adjudication of infusion and related claim information specific to health … more
- Molina Healthcare (Augusta, GA)
- … of pharmacy prior authorization requests and/or appeals. * Explains point-of-sale claims adjudication , state, NCQA and CMS policies/guidelines, and any other ... Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Essential Job… more