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Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and commercial payers. Minimum of one year revenue cycle management experience or related experience. Problem-solving skills to research and resolve discrepancies, denials, appeals, and collections.
Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Knowledge of Medicare, Medicaid and commercial insurance procedures required. Medical PPO high and low deductible plans / HSA options as well as HMO options in some markets. We are seeking an Admissions Coordinator to join our team.
$21.5 - $29.52 an hourExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Patient Base: Pediatric care, Medicaid office with some PPO patients. Part-Time - 2 days a week - Fridays are a must. Join a thriving pediatric practice in Hermitage TN with an exceptional opportunity for a productive dentist to build their success.
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Support the providers in preparing infrastructure for quality management implementation through activities such as advising on proper documentation, billing, and coding, pre-screening appointments, and helping to improve Medicaid and Commercial/CCA HEDIS scores.
$80,000 - $100,000 a yearFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Remain free from exclusion under the OIG and SAMS Medicare/Medicaid lists. Nationwide Blue Cross Blue Shield PPO with employee-friendly plan design, including a $850 individual annual medical deductible and $25 office visit copays, with low biweekly premiums.
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Bachelors degree Business, Sales, Marketing, or a related field from an accredited college / university or 10+ years of equally relevant experience. Maxor is seeking a Vice President of Revenue Operations to join our Pharmacy Operations Team. The Vice President of Revenue Operations plays a pivotal role in orchestrating the strategic direction and efficiency of revenue-related functions across Maxor's threebusiness units: Pharmacy Services, MaxorPlus, and Gateway.
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With a workforce of 1,100+ and almost a century of pharmacy experience, we offer the stability of a Fortune 500 company and the energy and innovation of a startup. Our expertise and technology support the entire pharmacy ecosystem, but our impact goes beyond pharmacy services.
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Nationwide Blue Cross Blue Shield PPO with employee friendly plan design, including $850 individual annual medical deductible, $25 office visit copays, Low biweekly premiums. The Prior Authorization Pharmacist provides educational and consultant services in the field of pharmacology and drug therapy medical professionals.
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Rx, dental, vision, short-term disability, and FSA. Review prior authorization requests using predetermined criteria and other medication resources. Perform retrospective drug utilization review: identify drug, physician and patient utilization trends; make interventions as appropriate via letters, phone calls, meetings, educational programs, mail order intervention programs; monitor and document outcomes as needed.
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Previous EDI, Dental, Medicaid or Medicare claims processing is a plus. · 5 years of experience in healthcare claims processing in a managed care and/or PPO/indemnity environment. Must have the ability to read/interpret contracts, standard reference materials (PDR, CPT, ICD-9, ICD-10, and HCPCS.
RemoteExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Remote, home-based within the Continental US. 10+ years experience in leadership roles demonstrating success in supporting B2B healthcare service and/or technology sales, ideally in the pharmacy services and/or pharmacy benefit management spaces.
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Extensive experience in sales and revenue management within a dynamic and competitive business environment. Oversee and maintain the Salesforce Customer Relationship Management (CRM) system, ensuring accurate and up-to-date data entry and integration to support sales initiatives.
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Rx, dental, vision, other voluntary benefits, and FSA. Current awareness of the PBM and Pharmacy Services industries trends and market dynamics. Leading cross-functional collaboration, the Vice President of Revenue Operations collaborates with the business unit sales teams, finance, IT, and marketing to ensure alignment with revenue objectives.
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A thorough understanding of insurance websites, ICD-10, working with referral coordinators, understands all different insurance lines of services, HMO, PPO, Commercial, Medicare HMO, Medicaid HMO, etc.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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A company of 1,000 diverse people and almost 100 years of pharmacy experience, we offer the stability of a Fortune 500 company with the energy and innovation of a startup. One to two years experience in the managed care and pharmacy benefit management (PBM) industries preferred.
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