• Pharmacy Claims

    Humana (Austin, TX)
    **Become a part of our caring community and help us put health first** The Pharmacy Claims Representative assists local pharmacies with claims ... up and maintaining hospice/facility/ pharmacy relationships under the direction of the Pharmacy Claims Team Leaders & the Pharmacy Claims (Support… more
    Humana (04/30/25)
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  • Utilization Management Representative II…

    Elevance Health (San Antonio, TX)
    **Be Part of an Extraordinary Team** BioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of ... support throughout the consumer's treatment journey. **Title:** Utilization Management Representative II - Prior Authorization **Location:** Onsite at 4751 Hamilton… more
    Elevance Health (04/16/25)
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  • Billing Representative

    Specialty Rx, Inc. (Austin, TX)
    pharmacy + Experience in Long Term Care Pharmacy preferred + Experience in Pharmacy billing claims preferred + Must be able to work independently and as a ... Job Description Our Company SpecialtyRx is a Long-Term Care pharmacy providing pharmaceutical services to long term care facilities and assisted living communities.… more
    Specialty Rx, Inc. (03/19/25)
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  • Bilingual FL Medicaid Call Center…

    Humana (Austin, TX)
    …Provider claims inquiries, grievances and appeals, transportation needs, and pharmacy support. **Use your skills to make an impact** **Required Qualifications** ... in a best-in-class contact center. As a Contact Center Representative 2, you will provide coverage for **Eastern Time...120 days of employment as an Inbound Contact Center Representative constitute an appraisal period. This Appraisal Period is… more
    Humana (04/29/25)
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  • Consumer Care Advocate

    Sedgwick (Irving, TX)
    …Workplace(R) Forbes Best-in-State Employer Consumer Care Advocate **Leave of Absence Representative ** **Our teams connect!** **We collaborate onsite and have a ... and voicemails from claimants, providers, clients, attorneys, etc., resolving their claims related questions and issues in accordance with designed guidelines and… more
    Sedgwick (03/04/25)
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  • Reconciliation Clerk

    Omnicell (Fort Worth, TX)
    …forms into FDS Amplicare Reconciliation applications. + Electronic filing of customer claims information into FDS Amplicare SharePoint site. + Support Senior Analyst ... (GED) **Preferred:** + Billing or reconciliation experience preferred + Pharmacy industry knowledge preferred + 10 Key Typing highly...The work environment and physical demands described here are representative of those that must be met by an… more
    Omnicell (03/28/25)
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  • Director Health Plan Quality Analytics

    Baylor Scott & White Health (Dallas, TX)
    …programs. Develops and executes data strategies for analyzing quality metrics, including claims , pharmacy , and EMR data. Ensures accurate and timely delivery ... quality data solutions. - Collaboration & External Engagement: Serves as a representative to external quality and data organizations (CMS, NCQA, State Medicaid… more
    Baylor Scott & White Health (04/12/25)
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