Pharmacy Claims Coordinator
2 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. What You\'ll Bring 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. Seniority level Not Applicable Employment type Full-time Job function Finance and Sales Industries Individual and Family Services #J-18808-Ljbffr
-
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...
-
Cebu City, Philippines KMC Solutions Full timeJob Overview Work on-site at our Cebu office Night shift Pharmacy 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 Prepares and completes retrospective desktop, and targeted audits, including obtaining claim data for analysis,...
-
Pharmacy Audit Support Representative
2 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...
-
Claims Handler Manager
2 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...
-
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
7 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 Coordinator
2 weeks ago
Quezon City, National Capital Region, Philippines Intogreat Solutions Full time ₱40,000 - ₱80,000 per yearGet Rewarded Fast with Our Sign-on BonusStart with us and unlock a generous sign-on bonus:-50% paid within 30 days of your start date.-The remaining 50% paid within 60 days.Join us and enjoy this exciting perk as you kickstart your career with usValid only for job offers extended until December 2025Purpose of the role:The Claims Coordinator will be based...
-
Claim Assistant
4 days ago
Cebu City, Philippines Access Care Proactive Health Full timeJob Title: Claims Specialist Location: Onsite – Cabancalan, Mandaue City, CebuSchedule: Monday to Friday | Shifting schedule (mostly 8:00 PM – 5:00 AM )Employment Type: Full-time About the Role We are looking for a highly organized and detail-oriented Claims Specialist to join our healthcare operations team. This role ensures that all insurance claims...
-
Clinical Program Coordinator
4 weeks 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 Coordinator
3 weeks ago
Davao City, Philippines CUBEWORK.COM PH CORP Full timeThe Claim Coordinator is responsible for supporting the end-to-end claims process related to transportation, warehousing, and customer disputes. This role ensures timely collection of supporting documents, accurate claim validation, and clear communication with internal teams, carriers, and customers. The member plays a critical role in reducing revenue...