Ohio Licensed Pre-Payment Claims AnalystVirtualVocations • Irvine, California, United States
Ohio Licensed Pre-Payment Claims Analyst
VirtualVocations • Irvine, California, United States
job_description.job_card.variable_hours_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
job_description.job_card.job_description
A company is looking for a Pre-Payment Claims Analyst to analyze pharmacy claim data and identify overpayments.
Key Responsibilities
Research and analyze pre-payment pharmacy claim data to identify overpayments and errors
Develop and update educational materials, workflows, and operational reports
Review and audit pharmacy claims for accuracy and compliance, and resolve related concerns
Required Qualifications, Training, and Education
National Pharmacy Technician Certification (CPhT) required
Bachelor's or Master's degree in a related field preferred, or equivalent work experience
Minimum of 2 years of experience in claim analytics or related healthcare fields
Proficient in Microsoft Office, especially Excel and Access
Working knowledge of pharmacy claims payment processes and systems
serp_jobs.job_alerts.create_a_job
Claim • Irvine, California, United States
Job_description.internal_linking.related_jobs
Tri-City Medical Center has served San Diego County's coastal communities for more than 60 years and is one of the largest employers in North San Diego County.
Tri-City is vital to the well-being of...serp_jobs.internal_linking.show_more
Every person deserves compassion, dignity, and the safety of a place to call home.Homelessness is the largest social and public health crisis in California.
Illumination Health + Home is a growing n...serp_jobs.internal_linking.show_more
Allied Universal, North America's leading security and facility services company, offers rewarding careers that provide you a sense of purpose.
While working in a dynamic, welcoming, and collaborati...serp_jobs.internal_linking.show_more
Sompo has a unique opportunity for a Claims Tpa Business Analyst in our Claim Operations team.This role will serve as a critical liaison between business stakeholders, Third Party Administrators (T...serp_jobs.internal_linking.show_more
This includes supervising daily operations, leading quality assurance programs, and collaborating with executive leadership to align departmental strategies with organizational goals.The ideal cand...serp_jobs.internal_linking.show_more
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country.
The actual salary for this position wi...serp_jobs.internal_linking.show_more
Extended hours may be required during catastrophes or spike claims volume.Flexibility to travel on short notice, up to 50% of the time, and ability to be on call required.If selected for this role,...serp_jobs.internal_linking.show_more
Center of Medicaid and Medicare Services (CMS) and Texas Department of Insurance for a Medicare Advantage Prescription Drug (MAPD) plan.
We are committed to the idea that healthcare should be easily...serp_jobs.internal_linking.show_more
Join an Award-Winning, Fast-Growing Allstate Agency in California! Looking for "A" Team Players!!.If you're ready to take your career to the next level, Todd Caviglia Insurance Agency...serp_jobs.internal_linking.show_more
At QBE, we are always looking to connect with top talent for current vacancies as well as for future opportunities.It is our aim to continuously build a strong candidate pipeline across all our bu...serp_jobs.internal_linking.show_more
Every person deserves compassion, dignity, and the safety of a place to call home.Homelessness is the largest social and public health crisis in California.
Illumination health + home is a growing n...serp_jobs.internal_linking.show_more
Pricing Configuration Specialist.Position Summary : Responsible for pricing configurations in our proprietary Product and Pricing Engine (PPE).
Ensures the performance of all duties in accordance wit...serp_jobs.internal_linking.show_more
General Liability Claims Examiner (Public Entity).By joining Sedgwick, you'll be part of something truly meaningful.It's what our 33,000 colleagues do every day for people around the world who are ...serp_jobs.internal_linking.show_more
Must have two years' healthcare claims experience.Our client is seeking a detail-oriented Claims Examiner to review, analyze, and process medical claims with a focus on accuracy and compliance.The ...serp_jobs.internal_linking.show_more
Crum & Forster Company Overview.Crum & Forster (C&F), with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines...serp_jobs.internal_linking.show_more
Golden State Foods is a distinguished leader in the foodservice industry, offering an extensive array of products and services to a diverse clientele.
Rooted in the values of quality service and int...serp_jobs.internal_linking.show_more
This position is eligible for Medical, Dental, Vision, and 401(k).The Prevailing Wage Analyst will be responsible for ensuring the accuracy, completeness, and compliance of payroll data associated ...serp_jobs.internal_linking.show_more
CA WC Senior Claims Specialist (SIP) 4850.Claims Specialist for our Southern California Team.Claims Specialist manages within company standards and best practices complex and problematic, high visi...serp_jobs.internal_linking.show_more
Pavement Recycling Systems is the Western United States premier provider of Recycling Solutions to reclaim, preserve, and rehabilitate pavement at any stage.
Becoming a team member of PRS introduces...serp_jobs.internal_linking.show_more
This includes supervising daily operations, leading quality assurance programs, and collaborating with executive leadership to align departmental strategies with organizational goals.The ideal cand...serp_jobs.internal_linking.show_more
PAYER ANALYST REPORT & RECOVERY - NON-GOVERNMENT ACCOUNTS
Tri-City Medical Center • Oceanside, CA, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Claims Specialist
Illumination Foundation • Santa Ana, CA, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Benefits Billing Analyst
Allied Universal • Irvine, CA, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Claims TPA Business Analyst
Sompo International • Irvine, CA, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Sr. Claims Director
Webilent Technology, Inc. • Huntington Beach, CA, United States
serp_jobs.job_card.temporary
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Sr. Claim Representative Construction Liability
Travelers • Irvine, CA, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Property Claims Specialist Field II- CAT / Spikes Team
Mercury General • Brea, CA, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Claims Director
Verda Healthcare Inc • Huntington Beach, CA, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Bilingual Licensed Insurance Representative
Todd Allstate Insurance • Anaheim, CA, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Claims Specialist - Crop
QBE Insurance • Irvine, CA, US
serp_jobs.job_card.full_time +1
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Claims Specialist
Illumination Health + Home • Santa Ana, CA, US
serp_jobs.job_card.full_time
serp_jobs.filters_job_card.quick_apply
serp_jobs.last_updated.last_updated_variable_days
Pricing Analyst
loanDepot • Irvine, CA, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Liability Claims Examiner (Public Entity) | Must Reside in California
Sedgwick • Brea, CA, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Claims Specialist
VanderHouwen • Whittier, CA, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Claims Analyst - Workers Comp - Medical Only - West Coast - Remote
Crum & Forster • Orange, CA, US
serp_jobs.filters.remote
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Sr. Corporate Claims Specialist
Golden State Foods • Irvine, CA, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Prevailing Wage Analyst
Addison Group • Santa Ana, CA, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
CA WC Senior Claims Specialist (SIP) 4850
CorVel • Rancho Cucamonga, CA, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Claims Specialist
PRS Holdings Inc. • Jurupa Valley, CA, United States
serp_jobs.job_card.full_time
serp_jobs.filters_job_card.quick_apply
serp_jobs.last_updated.last_updated_variable_days
Sr. Claims Director (Huntington Beach)
Webilent Technology, Inc. • Huntington Beach, CA, United States
serp_jobs.job_card.temporary
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted