Current jobs related to Pharmacy Adjudication Specialist - New Hyde Park - Onco360
-
Pharmacy Claims Adjudication Specialist
4 weeks ago
New Hyde Park, New York, United States Onco360 Full timeJob Title: Pharmacy Adjudication SpecialistWe are seeking a highly skilled Pharmacy Adjudication Specialist to join our team at Onco360 Pharmacy in New Hyde Park, NY. This is a full-time position with a hybrid work style, requiring a driving distance to our pharmacy.Job Summary:The Pharmacy Adjudication Specialist will be responsible for adjudicating...
-
Pharmacy Claims Adjudication Specialist
4 weeks ago
New Hyde Park, New York, United States Onco360 Full timeJob Title: Pharmacy Adjudication SpecialistWe are seeking a highly skilled Pharmacy Adjudication Specialist to join our team at Onco360 Pharmacy in New Hyde Park, NY. This is a full-time position with a hybrid work style, requiring a location within driving distance to our pharmacy.Key Responsibilities:Adjudicate pharmacy claims, review claim responses for...
-
Pharmacy Technician
4 weeks ago
New York, New York, United States MetroPlusHealth Full timeEmpowering New Yorkers through Healthcare ExcellenceMetroPlusHealth is dedicated to delivering exceptional healthcare services to the residents of New York City. Our mission is to provide high-quality care that empowers individuals and communities to thrive. If you share our passion for healthcare and are committed to making a difference, we invite you to...
-
Prior Authorization Pharmacy Technician
1 month ago
New York, United States NYC Health Hospitals Full timeMetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned...
-
Prior Authorization Review Pharmacy Technician
2 months ago
New York, United States NYC Health Hospitals Full timeMetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly owned...
-
Prior Authorization Pharmacy Technician
1 month ago
New York, United States MetroPlusHealth Full timeEmpower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day. About NYC Health + Hospitals MetroPlusHealth provides the highest...
-
Pharmacy Technician
4 weeks ago
New York, New York, United States MetroPlusHealth Full timeEmpower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health + HospitalsMetroPlusHealth provides the highest...
-
Prior Authorization Review Pharmacy Technician
1 month ago
New York, United States MetroPlusHealth Full timeEmpower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day. About NYC Health + Hospitals MetroPlusHealth provides the highest...
-
Pharmacy Technician Specialist
4 weeks ago
New Hyde Park, New York, United States CVS Health Full timePharmacy Technician Role at CVS HealthAt CVS Health, we're committed to delivering exceptional patient care and improving health outcomes. As a Pharmacy Technician, you'll play a vital role in supporting our pharmacists and ensuring the smooth operation of our pharmacies.Key Responsibilities:Assist pharmacists with dispensing medications and providing...
-
Pharmacy Packaging Specialist
4 weeks ago
New Hyde Park, New York, United States A-Line Staffing Solutions Full timePharmacy Packaging Technician OpportunityA-Line Staffing Solutions is seeking a skilled Pharmacy Packaging Technician to join our team. As a Pharmacy Packaging Technician, you will play a crucial role in ensuring the accurate and efficient packaging of medications for dispensing and delivery.Key Responsibilities:Fills prescription items, packaging...
-
Pharmacy Technician Specialist
1 month ago
New Hyde Park, New York, United States Onco360 Full timePharmacy Technician OpportunityWe are seeking a skilled Pharmacy Technician to join our Specialty Pharmacy team at Onco360. As a Pharmacy Technician, you will play a vital role in ensuring the safe and efficient dispensing of medications to our patients.Key Responsibilities:Maintain a safe and clean pharmacy environment by adhering to procedures, rules, and...
-
Pharmacy Authorization Specialist
4 weeks ago
New York, New York, United States MetroPlus Health Plan Full timeJob SummaryMetroPlusHealth is seeking a highly skilled Pharmacy Technician to join our team as a Prior Authorization Review Technician. In this role, you will be responsible for reviewing and processing prior authorization requests, ensuring accurate and timely decision-making. Your exceptional organizational and communication skills will enable you to...
-
Pharmacy Billing Lead
3 weeks ago
New Port Richey, Florida, United States Guardian Pharmacy, LLC Full timeJob Title: Lead Billing Specialist in PharmacyGuardian Pharmacy, LLC is seeking a highly skilled and experienced Lead Billing Specialist to join our team in North Port, Florida. As a Lead Billing Specialist, you will be responsible for supporting and leading the daily operations of the billing function, assisting pharmacy management in daily operational...
-
Pharmacy Authorization Review Specialist
4 weeks ago
New York, New York, United States MetroPlus Health Plan Full timeJob SummaryMetroPlusHealth is seeking a skilled Pharmacy Authorization Reviewer to join our team. As a Pharmacy Authorization Reviewer, you will be responsible for reviewing and processing prior authorization requests for pharmacy benefits. This role requires strong analytical and communication skills, as well as the ability to work independently and as part...
-
Pharmacy Technician
4 weeks ago
New York, New York, United States NYC Health Hospitals Full timeJob Title: Prior Authorization Review Pharmacy TechnicianAs a Prior Authorization Review Pharmacy Technician at NYC Health + Hospitals, you will play a critical role in ensuring that our members receive the necessary medications and treatments in a timely and efficient manner.Key Responsibilities:Input and review prior authorization requests for medical and...
-
Pharmacy Support Specialist
3 weeks ago
New York, United States Allure Specialty Pharmacy Full timeJob DescriptionAt Allure Specialty Pharmacy, we are seeking a skilled Pharmacy Technician to join our team. As a Pharmacy Technician, you will play a vital role in ensuring the smooth operation of our pharmacy services.Key Responsibilities:• Receives and verifies written prescriptions or refill requests for accuracy.• Mixes pharmaceutical preparations...
-
Pharmacy Technician
4 weeks ago
New Hyde Park, New York, United States Onco360 Full timeJob Title: Pharmacy Technician - Data Entry/IntakeOnco360 is seeking a highly skilled Pharmacy Technician to join our team in New Hyde Park, NY. As a Pharmacy Technician, you will play a critical role in ensuring the smooth operation of our specialty pharmacy.Key Responsibilities:Create and manage patient profiles, processing orders in a timely manner from...
-
Pharmacy Intern II
1 month ago
New York, United States NYC Health Hospitals Full timeMetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned...
-
Pharmacy Technician
4 weeks ago
New Hampton, Iowa, United States Towncrest Pharmacy Full timeJob SummaryTowncrest Pharmacy is a progressive independent community pharmacy seeking a highly skilled Pharmacy Technician to join our team at our Bennett Pharmacy location in New Hampton. As a Pharmacy Technician, you will play a vital role in providing advanced patient care services to patients of all ages.The ideal candidate will have excellent...
-
Pharmacy Care Specialist
2 weeks ago
New York, New York, United States Los primos pharmacy Full timeLos primos pharmacy is seeking a dedicated and experienced Pharmacist to provide exceptional pharmaceutical care to our patients.Key ResponsibilitiesDispense prescription medications to patients in a safe and timely manner.Provide accurate and reliable drug information to patients and healthcare professionals.Monitor and check for potential drug interactions...
Pharmacy Adjudication Specialist
2 months ago
We are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy in New Hyde Park, NY. This will be a Full-Time position. There are two shifts available: Monday to Friday, 11:30 am to 8 pm EST and 9:30 am to 6 pm EST. This position must be located within driving distance to our pharmacy, with a hybrid work style. Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers. Starting salary from $23.00 an hour and up We offer a variety of benefits including: Medical; Dental; Vision 401k with a match Paid Time Off and Paid Holidays Tuition Reimbursement Company paid benefits – life; and short and long-term disability Pharmacy Adjudication Specialist Major Responsibilities: The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy, ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections. Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests. Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding active claims information. Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information. Adjudicates pharmacy claims for prescriptions in active workflow for primary, secondary, and tertiary pharmacy plans and reviews claim responses for accuracy before accepting the claim. Contacts insurance companies to resolve third-party rejections and ensures pharmacy claim rejections are resolved to allow for timely shipping of medications. Performs outreach calls to patients or providers to reschedule their medication deliveries if claim resolution cannot be completed by ship date and causes shipment delays. Ensures copay cards are only applied to claims for eligible patients based on set criteria such as insurance type (Government beneficiaries not eligible). Manages all funding related adjudications and works as a liaison to Onco360 Advocate team. Assists pharmacy team with all management of electronically adjudicated claims to ensure all prescription delivery assessments are reconciled and copay payments are charged prior to shipment. Serves as customer service liaison to patients regarding financial responsibility prior to shipments, contacts patients to communicate any copay discrepancy between quoted amount and claim and collects payment if applicable. Documents and submits requests for Patient Refunds when appropriate. Pharmacy Adjudication Specialist Qualifications And Responsibilities: Education/Learning Experience Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification, Pharmacy Claims Adjudication. Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician, Specialty pharmacy experience. Work Experience Required: 1+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience. Desired: 3+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience. Skills/Knowledge Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills. Desired: Knowledge of Foundation Funding, Specialty pharmacy experience. Licenses/Certifications Required: Registration with Board of Pharmacy as required by state law. Desired: Certified Pharmacy Technician (PTCB). Behavior Competencies Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skills. #J-18808-Ljbffr
