Become a part of our caring community and help us put health first As a Mail Operations Pharmacy Technician, you will fill and counts medications. You will perform varied activities and moderately complex administrative/operational/customer support assignments. Perform computations. Typically, it works on semi-routine assignments. As a Mail Operations Pharmacy Technician 2 you will ensure inventory levels are adequate for dispensing by working with inventory supply team. You will work remotely and report to a leader in the Failed Claims department. Decisions are typically focused on interpretation of area/department policy and methods for completing assignments. Work within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follow standard policies that allow for some opportunity for interpretation/deviation and/or independent discretion. Use your skills to make an impact Required Qualifications - Must live in Arizona, Ohio, Texas or Florida - Must have an active license with the Board of Pharmacy in the state you reside - National Certification, PTCB or NHA - Experience using multiple computer applications simultaneously Preferred Qualifications - Failed Claim experience Additional Information **PLEASE MAKE SURE YOU ATTACH YOUR RESUME TO YOUR APPLICATION (PDF OR WORD FORMAT) ** Interview Process As part of our hiring process for this opportunity, we will be using technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $40,000 - $52,300 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us About CenterWell Pharmacy: CenterWell Pharmacy provides convenient, safe, reliable pharmacy services and is committed to excellence and quality. Through our home delivery and over-the-counter fulfillment services, specialty, and retail pharmacy locations, we provide customers simple, integrated solutions every time. We care for patients with chronic and complex illnesses, as well as offer personalized clinical and educational services to improve health outcomes and drive superior medication adherence. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.​ Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Job Posting Closing Date: Open until Filled Where do you belong? Your career is more than just a job, it's part of your life. Whether you’re a clinician, or non-clinical professional, at USACS you'll feel a sense of connection working with clinicians and office staff who share your interests and values. We want you to love coming to work each day because you believe in what you do and the people with whom you work. We care about your success. USACS also understands that location is important. We offer career opportunities for clinicians and non-clinical support staff from New York to Hawaii and numerous points in between. Our supportive culture, outstanding benefits and competitive compensation package is best in class. Job Description The Coding Education Specialist research complex coding issues and recommend resolutions. Identify training needs and develop processes. Skilled Coding Education Specialists are passionate educators who design, develop, and deliver engaging coding curricula to learners of various skill levels. This includes the ability to translate complex coding concepts into accessible learning experiences. Location: Remote ESSENTIAL JOB FUNCTIONS: - Curriculum Development: Design and update coding lessons, projects, and assessments tailored to different learning objectives and audiences, including USACS and vendor coders. - Instruction & Facilitation: Deliver high-quality, engaging instruction using platforms like OnBase, Pulse, Workday and Articulate through in-person or virtual classrooms. - Learner Support: Monitor student progress, provide feedback, and offer one-on-one or group support to ensure learner success. - Assessment & Reporting: Measure student performance through formative and summative assessments; analyze and report data to inform instructional improvements. - Community Engagement: Participate in external training programs by presenting tailored materials to engage interest in joining our internal coding team. Example: Stark State College coding program. - Resource creation & maintenance: Create and maintain coding resources that assist coders in applying organizational policy to broad coding concepts (e.g., SOPs, site pages, etc.). - Industry Monitoring: As a member of the Industry Monitoring team, research coding topics or issues, create problem statements, provide recommendations, and develop and present education and/or continuous improvement updates. - Regular Collaborations with all RCM internal teams to ensure coding processes, guidelines, and policies are accurately applied. - Provide educational consults for internal Coding Department staff when applicable. - Assist in preparation for QA Webinars, quarterly coding meetings, and vendor calibration calls and actively participate in both. - Analyze and trend audit results to identify root causes, then create and launch targeted education. Followed by monitoring audit results to confirm expected improvement. - Create and launch coder edits to mitigate areas of risk followed by monitoring to confirm expected results. - Performs and assists with other department duties as needed. KNOWLEDGE, SKILLS AND ABILITIES: - Knowledge of and experience using ICD-10-CM and CPT coding. - Knowledge of payor and coding guidelines. - Knowledge of and skill in using personal computers in a Windows environment with an emphasis on PowerPoint and Zoom. - Ability to pay close attention to detail and be multi-task oriented - Ability to identify research and solve problems and discrepancies. - Ability to communicate with employees, management, and physicians in a courteous professional manner. - Ability to maintain confidentiality. - Strong organizational skills with an ability to maintain multiple competing priorities. EDUCATION AND EXPERIENCE: - High school diploma or equivalent - RHIT, RN, CPC or CCS-P accreditation. - Emergency Department pro-fee coding experience PHYSICAL DEMANDS: - While performing the duties of this job, the employee is regularly required to sit for prolonged periods and occasionally walk, stand, bend, stoop, and lift up to 15 pounds. - Required to have close visual acuity to perform job Hourly Rate: $24.83-$45.93 Hourly rate may be determined on several factors including but not limited to knowledge, skills, experience, education, geographical location and requirements stated in job description. US Acute Care Solutions current and potential employees enjoy best in class benefit programs with a wide array of options. To learn more, please visit the following link: http://www.usacs.com/benefits-guide Click the red apply button to submit an application and resume. If you are an USACS employee, please apply via the Jobs Hub in the Workday system.

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Clinical Pharmacy Technician Sr. Medi-Cal Rx - Remote in CaliforniaJob Description Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria. Responsibilities - Determines appropriateness for medications. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists. Researches, resolves and documents prior authorization outcomes in pharmacy system. - Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician`s office staff, medical management staff and/or pharmacists. - Escalates requests to Pharmacist when request requires extensive clinical review or denial. - Monitors telephone system to ensure adequate staffing to maintain client services levels. - Assesses training needs within the team. Serves as a training resource, mentor and coach to others. Identifies and shares best practices. - Demonstrates, advocates and reinforces a positive team environment. - Other duties as assigned. Minimum Qualifications - GED - High School - LPT - Licensed Pharmacy Technician - 2 years relevant work experience Must be eligible to work in the United States without the need for work visa or residency sponsorship Additional Qualifications - LPT: Licensure in accordance with California state requirements. - Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting. - In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.). - Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite. - Excellent written and verbal communication skills. - Ability to follow clinical criteria and instructions to approve prior authorization requests. - Minimum of 2 years dispensing or retail experience required, or equivalent internal training will be substituted. - Ability to identify and trouble-shoot problematic issues. Preferred Qualifications Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job. Potential pay for this position ranges from $19.23 - $28.85 based on experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits). Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.   We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law. Prime Therapeutics LLC is a Tobacco-Free Workplace employer. Positions will be posted for a minimum of five consecutive workdays.

• Responsible for timely and accurate coding and abstracting of Inpatient visits • Codes and abstract patients following established coding guidelines and utilizing ICD-10 code sets • Ensures that revenue cycle, customer service, quality, individual, and team goals are met • Thoroughly review of inpatient encounter documentation for diagnoses, treatments, services • Performs daily coding and abstracting utilizing ICD-10 Code sets and DRG Grouping systems • Validates MS-DRG and APR-DRG assignment for appropriateness to encounter • Performs weekly coding of Inpatient Interim Bill Requests • Review of Clinical Documentation Specialists notes and queries to ensure capture of queried conditions • Validates admission diagnosis assignment and coordinates correction with Case Management personnel when appropriate • Identifies documentation issues that may lead to incorrect coding, billing, and quality metrics • Communicates issues to Clinical Documentation Specialists for clarification and/or resolution when appropriate • Facilitates accurate Hospital Acquired Conditions reporting with Infection Control and/or coordinates retrospective query with CDI team as appropriate • Performs research and/or seeks assistance from Nosology, CHA and American Hospital Association on complex coding cases • Documents findings and educates team on coding guidance • Makes recommendations on Epic coding and SVC edits to prevent coding, billing, IHA and claim edits • Maintains quality standards of AHA, AMA, CMS, OIG and TJC pertaining to coding and reimbursement • Stay current in Coding changes by reading, maintaining CEUs, and attending education sessions related to Coding and Health Information Management • Trains and orients new employees • Assists with testing and implementation of systems/product changes and upgrades • Performs other duties as assigned by the coding manager or the director