
Pharmacy Claims Coordinator
4 weeks ago
Overview
We\'re looking for a Pharmacy Claims Auditor to safeguard our claims data and prevent fraud. You\'ll conduct audits, analyze billing activities, and ensure compliance with regulations.
What Youll Do- Conduct desk and on-site pharmacy audits.
- Review claims for errors, discrepancies, or fraud.
- Communicate with pharmacies to resolve billing issues.
- Prepare audit reports and recommend corrective actions.
- Document findings and ensure client invoicing accuracy.
- Bachelor\'s degree + 1 year pharmacy experience (Long Term Care, Specialty, or Mail Order a plus).
- Pharmacy Technician license required; national certification preferred.
- Strong knowledge of pharmacy practice, laws, and regulations.
- Proficient in MS Office; SQL/SAS knowledge a plus.
- Excellent analytical, problem-solving, and communication skills.
- Not Applicable
- Full-time
- Finance and Sales
- Individual and Family Services
-
Pharmacy Claims Compliance Specialist
2 weeks ago
Cebu City, Central Visayas, Philippines KMC Solutions Full time ₱900,000 - ₱1,200,000 per yearJob Overview:Work on-site at our Cebu officeNight shiftPharmacy degree (Pharm. D.) or equivalent; and 2+ years related retail experience and/or training; or equivalent combination of education and experience.Essential Duties and Responsibilities include the following. Other duties may be assigned.Prepares and completes retrospective desktop, and targeted...
-
Pharmacy Audit Support Representative
4 weeks ago
Cebu City, Philippines Comercial Navero y Elvira Pol. Ind. Postuero - Nave 7-8 Full timeJoin to apply for the Pharmacy Audit Support Representative role at Comercial Navero y Elvira Pol. Ind. Postuero - Nave 7-8 About The Role We are seeking a Pharmacy Audit Support Representative to join our team. This role is responsible for reviewing and analyzing pharmacy claims to ensure compliance with regulations and company standards. The position...
-
Project-based Pharmacy Coordinator
1 week ago
Makati City, National Capital Region, Philippines KMC Solutions Full time ₱1,200,000 - ₱2,400,000 per yearJob Overview:Hybrid work setup (2 to 3 days on-site)Site at Makati or CebuProject-based for 5 to 6 months with no guarantee of extensionFixed night shiftHas pharmacy background3 to 5 years of coordinating projects / programs is requiredSummary:The Clinical Program Coordinator coordinates the implementation and ongoing operational functions. Reviews program...
-
Claims Processing Specialist I
6 days ago
Quezon City, National Capital Region, Philippines StayWell Information Systems, Inc. Full time ₱300,000 - ₱450,000 per yearReview and evaluate data on claim forms and supporting documents.Process for payment on- and off-island medical, dental, and pharmacy claims.Review and verify authorized charges on claim statements.Prepare correspondence to providers regarding billing issues and benefit coverage.Handle data entry of medical, dental and pharmacy claims into the computer for...
-
Claims Handler Manager
4 weeks ago
Quezon City, Philippines P and I Claims Management Inc. Full timeOverview On-site - Quezon City Fresh Graduate/Student Diploma Full-time HR Officer P and I Claims Management Inc. Job Description Reports directly to the Head of Operation Analyze and evaluate the claims based on the relevant documents submitted to determine whether the claims are valid, and to establish the party liable. Prepares full report for the Head of...
-
Claims Analyst
4 weeks ago
Quezon City, Philippines 1 Cooperative Insurance System of the Philippines Life and General Insurance Full timeResponsibilities Updates claims database every time processed claims have new status; Processes all received claims; Coordinates with Medical Underwriting Consultant claims that needs medical expert opinion; Attends to agents and clients queries regarding status of their claims; Performs other tasks as required by immediate superior and/or higher Management....
-
Clinical Program Coordinator
7 days ago
Cebu City, Philippines Comercial Navero y Elvira Pol. Ind. Postuero - Nave 7-8 Full timeAbout The Role We are seeking a detail-oriented Clinical Program Coordinator to manage the implementation and ongoing operations of our clinical programs. This role ensures program configurations meet design requirements, performs quality checks in pre-production, and collaborates across teams to deliver accurate, efficient, and client-focused solutions. Key...
-
Claims Specialist
1 week ago
Cebu City, Central Visayas, Philippines Smartsourcing Full time ₱600,000 - ₱1,200,000 per yearAccuracy meets efficiency—be the difference in every claim's journey at Smartsourcing, a 5-Time Best Company to Work ForHi We're Smartsourcing, and we're looking for a full-time, onsite Vehicle Claims Adjuster to keep cases moving, documents in order, and deadlines on point. You'll handle claims, recoveries, and logistics tasks with precision—ensuring...
-
Pharmacy Assistant
1 week ago
Mandaluyong City, National Capital Region, Philippines Makati Hope Christian School - Ortigas Full time ₱150,000 - ₱250,000 per yearThe Pharmacy Assistant is responsible for the daily handling of transactions and interaction with customers, selling over-the-counter medicines.Takes in and hands out prescriptions.Attends to sales transactions following established procedures.Familiarizes self with products and educates self more about health and wellness.Prepares orders of merchandise and...
-
Vehicle Claims Officer
4 weeks ago
Cebu City, Philippines Smartsourcing Full timeSmartsourcing is hiring a full-time, onsite Vehicle Claims Adjuster to support claims, recoveries, and logistics workflows with accuracy and compliance across the lifecycle. Role: Vehicle Claims Adjuster — full-time, onsite. You will handle claims, recoveries, and logistics tasks with an emphasis on detail, workflow efficiency, and timely communication to...