Pharmacy Benefits Coordinator
16 hours ago
The Pharmacy Technician plays a vital role in ensuring the smooth operation of our pharmacy benefits program. As a key member of our team, you will be responsible for providing exceptional customer service, resolving member and provider inquiries, and working closely with pharmacists to review and process medication coverage requests.
Key Responsibilities- Customer Service: Provide timely and accurate responses to member and provider inquiries, resolving issues and escalating complex cases to clinical pharmacists or medical directors as needed.
- Medication Coverage Requests: Review and process medication coverage requests, attaching relevant policy information and escalating requests to clinical pharmacists or medical directors for review.
- Claims Processing: Assist pharmacies in processing prescription claims, reviewing and troubleshooting claims for accuracy and adherence to contract guidelines.
- Communication: Provide verbal verification of member plan eligibility and applicable pharmacy benefits, and communicate decision to physician's office and/or members through verbal and/or written notification.
- Documentation: Accurately document coverage request outcomes, member and provider inquiries, and grievances in our pharmacy benefit manager's system and medical review system.
- Education: High School diploma or equivalent.
- Certification: National Pharmacy Technician Certification.
- Experience: One year experience in a retail, hospital, managed care, or other similar pharmacy setting.
- Skills: Strong communication and problem-solving skills, with the ability to work effectively as part of a team and independently.
- Education: Degree in a health-related field.
- Experience: Experience performing medication authorizations in a pharmacy or managed care environment.
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Pharmacy Compliance and Regulatory Manager
3 weeks ago
Wheeling, West Virginia, United States The Health Plan of West Virginia Inc Full timeJob OverviewThe Pharmacy Compliance and Regulatory Manager plays a crucial role in ensuring that pharmacy operations adhere to all relevant federal, state, and accreditation standards. This position involves managing the pharmacy's interactions with its Pharmacy Benefit Manager (PBM) and overseeing various compliance-related activities.Key...
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Pharmacy Compliance and Regulatory Manager
4 weeks ago
Wheeling, West Virginia, United States The Health Plan of West Virginia Inc Full timeJob OverviewThe Manager of Pharmacy Compliance, Regulatory, and Accreditation is responsible for ensuring that pharmacy services adhere to all applicable federal, state, and accreditation agency regulations and standards. This role involves managing the relationship with the Pharmacy Benefit Manager (PBM) and overseeing quality improvement initiatives,...
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Pharmacy Intern
3 weeks ago
Wheeling, West Virginia, United States WVU Medicine Full timeJob SummaryWe are seeking a highly motivated and detail-oriented Pharmacy Intern to join our team at WVU Medicine. As a Pharmacy Intern, you will play a critical role in supporting our pharmacy operations and contributing to the delivery of exceptional patient care.Key ResponsibilitiesAssist in the preparation and dispensing of medications, including reading...
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Pharmacy Compliance and Regulatory Manager
3 weeks ago
Wheeling, West Virginia, United States The Health Plan of West Virginia Inc Full timeJob OverviewThe Manager of Pharmacy Compliance, Regulatory, and Accreditation plays a crucial role in ensuring that pharmacy operations adhere to federal, state, and accreditation agency regulations and standards. This position is responsible for overseeing the relationship with pharmacy benefit managers (PBMs), evaluating outcomes for quality enhancement,...
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Pharmacy Assistant
1 week ago
Wheeling, West Virginia, United States WVU Medicine Full timeJob SummaryWe are seeking a highly motivated and detail-oriented Pharmacy Intern to join our team at WVU Medicine. As a Pharmacy Intern, you will play a vital role in assisting pharmacists with various tasks, including medication preparation, delivery, and inventory management.Key ResponsibilitiesAssist pharmacists with reading physician's orders, preparing...
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Benefits Insurance Producer
2 weeks ago
Wheeling, West Virginia, United States WesBanco Bank, Inc Full time{"Job Title": "Benefits Insurance Producer", "Department": "Wesbanco Ins", "Location": "Wheeling", "Job Type": "Hybrid", "Work Hours per Week": "37.5", "Requirements": "High School Diploma or GED required. Associate or Bachelor's Degree preferred. Minimum five years of experience in group health insurance sales, or minimum of 5 years in a service/account...
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Registration Coordinator
2 weeks ago
Wheeling, West Virginia, United States WVU Medicine Full timeJob SummaryWe are seeking a highly organized and detail-oriented Registration Coordinator to join our team at WVU Medicine. As a key member of our healthcare team, you will be responsible for managing patient registration and financial obligations, ensuring seamless and efficient patient flow.Key ResponsibilitiesObtain and verify patient demographic and...
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Registration Coordinator
2 weeks ago
Wheeling, West Virginia, United States WVU Medicine Full timeJob SummaryWe are seeking a highly organized and detail-oriented Registration Coordinator to join our team at WVU Medicine. As a key member of our patient access department, you will be responsible for managing patient registration and financial obligations.Key ResponsibilitiesObtain and verify patient demographic and insurance information, ensuring accurate...
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Call Center Coordinator
3 weeks ago
Wheeling, West Virginia, United States The Health Plan of West Virginia, Inc. Full timeJob Summary:The Customer Service Coordinator position is responsible for assisting the Manager and Director with daily operational activities relating to the call center, which may include: claims payment issues, call monitoring, and providing team guidance and support.Key Responsibilities:Assist with Claims and Payment Issues: Collaborate with the Manager...
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Asset Protection Coordinator
3 days ago
Wheeling, West Virginia, United States Bass Pro Inc Full timeJob SummaryThe Asset Protection Coordinator is a critical role within our organization, responsible for maintaining and monitoring all asset protection, security, compliance, and safety-related functions within a facility. This position plays a vital part in reducing shrink, maintaining accurate inventory, ensuring compliance, and creating a safe and secure...
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Travel Nursing Position
2 days ago
Wheeling, West Virginia, United States GLC on the GO Full timeJob Title: Travel Nursing PositionWe are seeking an experienced Long Term Care Registered Nurse to join our team at GLC on the GO. As a travel nurse, you will have the opportunity to work in a variety of settings and locations, gaining valuable experience and skills.About GLC on the GOGLC on the GO is a leading healthcare staffing solutions provider,...
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Registration Coordinator
2 weeks ago
Wheeling, West Virginia, United States WVU Medicine Full timeJob SummaryWe are seeking a highly organized and detail-oriented Registration Specialist to join our team at WVU Medicine. As a key member of our registration team, you will be responsible for ensuring accurate and efficient patient registration and financial processing.Key ResponsibilitiesObtain and verify patient demographic and insurance informationEnter...
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Registration Coordinator
2 weeks ago
Wheeling, West Virginia, United States WVU Medicine Full timeJob SummaryWe are seeking a highly organized and detail-oriented Registration Specialist to join our team at WVU Medicine. As a key member of our patient access team, you will be responsible for managing patient registration and financial obligations.Key ResponsibilitiesObtain and verify patient demographic and insurance informationEnter data into...
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Administrative Coordinator
2 days ago
Wheeling, West Virginia, United States Panhandle Cleaning & Restoration Full timeAdministrative Support Role at Panhandle Cleaning & RestorationJob Summary:We are seeking a highly organized and detail-oriented Administrative Assistant to provide dedicated support to our Project Managers and Estimators. The ideal candidate will have a strong background in administrative tasks, excellent communication skills, and the ability to work in a...
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Travel Nurse RN
2 weeks ago
Wheeling, West Virginia, United States Cynet Health Full timeJob SummaryCynet Health is seeking a skilled Long Term Acute Care Registered Nurse to provide high-quality patient care in a dynamic and fast-paced environment. As a Long Term Acute Care Registered Nurse, you will be responsible for assessing, planning, and implementing client care for patients with chronic conditions and prolonged or incurable illnesses.Key...
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Finance and Human Resources Coordinator
4 weeks ago
Wheeling, West Virginia, United States Panhandle Cleaning & Restoration Full timeAccounting and HR Assistant Position OverviewWe are looking for a committed professional to support our accounting operations while also managing human resources responsibilities.Key Responsibilities:Reconcile financial statements and credit transactionsUtilize a Purchase Order system effectivelyUnderstand and apply job costing principlesAssist with...
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Finance and Human Resources Coordinator
4 weeks ago
Wheeling, West Virginia, United States Panhandle Cleaning & Restoration Full timeAccounting and HR Assistant Role OverviewWe are looking for a committed professional to support our accounting division while also handling various human resources responsibilities.Key Responsibilities:Reconcile financial statements for bank and credit card transactionsUtilize a Purchase Order system effectivelyComprehend job costing principlesAssist with...
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Safety and Security Specialist
1 day ago
Wheeling, West Virginia, United States Bass Pro Inc Full timeSafety and Security Coordinator Job SummaryWe are seeking a highly motivated and detail-oriented Safety and Security Coordinator to join our team at Bass Pro Inc. The successful candidate will be responsible for ensuring the safety and security of our distribution centers, facilitating compliance training, and conducting regular audits and inspections.Key...
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Safety and Security Specialist
7 days ago
Wheeling, West Virginia, United States Bass Pro Inc Full timeSafety and Security Coordinator Job SummaryWe are seeking a highly motivated and detail-oriented Safety and Security Coordinator to join our team at Bass Pro Inc. The successful candidate will be responsible for ensuring the safety and security of our distribution centers, while also facilitating compliance with company policies and procedures.Key...
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Safety and Security Specialist
3 days ago
Wheeling, West Virginia, United States Bass Pro Inc Full timeSafety and Security Coordinator Job SummaryWe are seeking a highly motivated and detail-oriented Safety and Security Coordinator to join our team at Bass Pro Inc. The successful candidate will be responsible for ensuring the safety and security of our distribution centers, while also facilitating compliance with company policies and procedures.Key...