• Medicare Part B/Billing Rep

    Specialty Rx, Inc. (Ridgefield Park, NJ)
    …SpecialtyRx is a full-service pharmacy . We need Medicare Part B- Billing Representative with Pharmacy experience in our Ridgefield Park, NJ location. Hours: ... a fast-paced environment is a must. + Experience in New York Pharmacy billing claims . (Preferred) + Frameworks/ECM knowledge is a plus. + Must be… more
    Specialty Rx, Inc. (09/05/25)
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  • Plan Administrative Analyst

    BrightSpring Health Services (Louisville, KY)
    …to work effectively with internal customers Microsoft office products + Knowledge of claims processing system or pharmacy practice system desired + Strong ... Our Company PharMerica Overview PharMericais a national leader in pharmacy services with over 30 years of experience, serving our partners in long-term care, senior… more
    BrightSpring Health Services (11/12/25)
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  • Benefits Verification Specialist

    Polaris Pharmacy Services, LLC (Covina, CA)
    …to meet payer requirements. . Accurately document benefit verification results in pharmacy systems. . Troubleshoot rejected claims and perform necessary claim ... Benefits Verification Specialist Job Details Job Location Polaris Specialty Pharmacy LLC - Covina, CA Salary Range $19.00 -...environment. PHYSICAL DEMANDS The physical demands described here are representative of those that should be met by an… more
    Polaris Pharmacy Services, LLC (11/19/25)
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  • Benefits Analyst, Account Manager

    CVS Health (Largo, FL)
    …client satisfaction, retention, and engagement by serving as a trusted onsite representative to our public sector client. This field-based role centers on delivering ... in-person support across multiple worksites, handling complex benefit and claims inquiries, and providing education during open enrollment and health-related… more
    CVS Health (11/16/25)
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  • Reporting Principal - Remote

    Prime Therapeutics (Montgomery, AL)
    …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
    Prime Therapeutics (10/30/25)
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  • Patient Account Rep

    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
    Crouse Hospital (11/12/25)
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  • Post-Doctoral Regulatory Affairs Fellow…

    Boehringer Ingelheim (Ridgefield, CT)
    …for our employees. The Fellow will serve as the Regulatory Affairs representative on the Human Pharma Review Committee (HPRC) team, working cross-functionally with ... and the current Regulatory landscape. The Fellow will review promotional claims and materials for Boehringer Ingelheim prescription drugs for compliance with… more
    Boehringer Ingelheim (11/28/25)
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  • UM Specialist LVN - Sharp Extended Care - Copley…

    Sharp HealthCare (San Diego, CA)
    …issued under the direction of the appropriate Medical Group Physician Representative .Identifies patients going into custodial level of care and appropriately ... Group Appeals on members with SNF services under appeals process.Reviews SNF claims for medical necessity and appropriateness when any information on the claim… more
    Sharp HealthCare (11/28/25)
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  • Dir Clinical Risk Management Operations EverGreen

    PeaceHealth (Vancouver, WA)
    …clinical risk management risk investigations and response to events, potential claims , and grievances presented against caregivers, physicians and the organization ... for potential or actual liability and damages. Collaborating with Claims , collects documents and evidence and maintains work product in accordance with state legal… more
    PeaceHealth (11/20/25)
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  • Healthcare Analyst Senior

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …Network and Pharmacy , ensuring data is pulled using the most representative methods. They also support high-risk regulatory reporting, where precision and speed ... synthesizes data across multiple domains, including utilization management, prior authorization, claims , denials, and appeals. Their work goes beyond extraction; it… more
    Blue Cross and Blue Shield of Minnesota (10/08/25)
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