Pharmacy Claims Coordinator

OverviewWe\'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 DoConduct desk and on-site pharmacy audits.Review claims for errors, discrepancies, or fraud.Communicate with pharmacies to resolve billing issues.Prepare...

Join to apply for the Pharmacy Audit Support Representative role at Comercial Navero y Elvira Pol. Ind. Postuero - Nave 7-8About The RoleWe 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...

Join 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...

Virtual Pharmacist Job DescriptionWe are seeking a skilled Virtual Pharmacist to join our team. The ideal candidate will have experience in pharmacy operations, claims management, and clinical pharmacy.Key Responsibilities:AI-Assisted Medication Verification: Use AI-driven tools to verify the accuracy of medications packed into dose-ready sachets.Cross-check...

Virtual Pharmacy SpecialistThis position involves working as a Virtual Pharmacy Specialist where you will be responsible for verifying the accuracy of medications packed into dose-ready sachets.As a pharmacy professional, you will use AI-driven tools to cross-check identified medications against prescriptions to ensure correct dosage and format. Your key...

Job 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...

Review 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...

Remote Medication ExpertReview and verify medication orders for accuracy and completeness. Collaborate with healthcare professionals to ensure seamless medication management.Key Responsibilities:Verify the accuracy of medications using AI-driven tools.Cross-check AI-identified medications against prescriptions.Flag missing or duplicate tablets, debris, or...

Responsibilities 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....

Overview 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...