Specialist, Coverage Determination

About the RoleAbarca Health is seeking a highly skilled and detail-oriented Coverage Determination Specialist to join our team. In this role, you will be responsible for creating and evaluating coverage determinations for our clients, communicating with pharmacists, beneficiaries, and doctors, and applying clinical knowledge to each case.Key...

About Abarca HealthAbarca Health is a revolutionary company that's redefining pharmacy benefits through smarter technology. Our mission is to deliver exceptional healthcare services while ensuring the satisfaction of our clients and beneficiaries.Job SummaryWe're seeking a highly skilled Coverage Determination Team Manager to oversee the Coverage...

What you'll do Abarca is igniting a revolution in healthcare. We built our company on the belief that with smarter technology we are redefining pharmacy benefits, but this is just the beginning. Abarca’s Service Operations team takes the charge by handling two areas of detail-oriented and quality care: Clinical Outreach and Services. From maintain the...

About the RoleAbarca Health is seeking a highly skilled Team Leader to oversee the Coverage Determination team. As a key member of our Service Operations team, you will be responsible for ensuring the timely and accurate resolution of Commercial and Medicare coverage determination cases.Key ResponsibilitiesMonitor calls and cases to ensure timely and...

About the roleAbarca Health is seeking a skilled professional to join our PBM Operations & Services team as a Coverage Determination Specialist.The ideal candidate will possess strong analytical skills and the ability to communicate effectively with pharmacists, beneficiaries, and doctors.Responsibilities will include reviewing and responding to coverage...

A career with Abarca Health awaits!Company OverviewAbarca Health is a revolutionary force in healthcare, igniting a wave of smarter technology to redefine pharmacy benefits.We're not just changing the game - we're redefining it. Our passion for innovation and customer satisfaction drives us to excel every day.Job SummaryWe're seeking an experienced Coverage...

Job SummaryRisk Strategies is seeking a highly skilled Senior Account Manager to join our team. As a key member of our Private Client Services group, you will be responsible for developing and maintaining strong relationships with our high net worth clients.Key ResponsibilitiesBuild and maintain constructive relationships with clients by meeting and...

About the RoleWe are seeking a skilled Healthcare Utilization Specialist to join our team at Elevance Health. This is an exciting opportunity for a motivated and detail-oriented individual to work in a dynamic environment.Job SummaryThe Healthcare Utilization Specialist will be responsible for conducting preauthorization reviews for diagnostic imaging...

AIG is a global leader in commercial and personal insurance solutions, seeking an experienced Risk Management Specialist to join our team.This role offers a unique opportunity to contribute to the development of innovative insurance solutions for clients across various industries. As a Risk Management Specialist, you will be responsible for evaluating risks,...

We are seeking an experienced Auto Bodily Injury Claims Specialist to join our team at First Chicago Insurance Company. Our new office in Oak Brook is now open, and we are excited to expand our operations in the area.The Bodily Injury Claims Specialist will be responsible for investigating and settling automobile bodily injury claims. They will work closely...

Job Title: Dental Care SpecialistAt Great Expressions Dental Centers, we're seeking a skilled Dental Care Specialist to join our team. As a key member of our dental practice, you'll be responsible for delivering high-quality oral care to our patients.Key Responsibilities:Conduct thorough dental exams and diagnose oral health issuesDevelop and implement...

At Mitchell Martin, we're seeking an experienced Diagnostic Imaging Specialist to join our team in a CT Technologist Position. As a Radiology Technician Role, you'll be responsible for performing routine radiological procedures and operating CT equipment to produce high-quality images of patients' bones, organs, and tissue. **Responsibilities:** • Operate...

We are seeking a highly skilled Customer Support Specialist to join our team at Colin Fane - State Farm Agent. As a Customer Support Specialist, you will be the first point of contact for our customers, providing exceptional service and support to ensure their needs are met.Key Responsibilities:Customer Support: Delivering exceptional customer service by...

We are seeking a highly skilled Risk Management Specialist to help our clients achieve their goals by implementing effective solutions to manage their risks. The ideal candidate will be responsible for advising internal and external producers on personal lines insurance, effectively managing risks, and completing the underwriting process in accordance with...

Job Title: Manager, Credit SpecialistKPMG-UnitedStates is seeking a skilled Credit Specialist Manager to join our Audit practice. As a key member of our team, you will be responsible for managing and supervising the execution of credit specialist components of external audit engagements for various clients, including Securities and Exchange Commission (SEC)...

About Red Ventures: Our company was founded in 2000, and we have a diverse portfolio of industry-leading brands and businesses. We are committed to helping millions of people worldwide make life's most important decisions by improving every step of the consumer journey. As a leading marketing and technology company, we employ thousands of people across the...

About the Role:As a Financial Claims Specialist at AIG, you will be responsible for assessing and managing complex liability claims within authority limits. You will perform coverage and quantum analysis throughout the claims' lifecycles, ensuring timely and accurate resolutions for our customers.What You'll Do:Proactively assess and manage complex liability...

Job SummaryWe are seeking a highly organized and detail-oriented Administrative Support Specialist to join our team. As a key member of our operations team, you will provide administrative support through generating and maintaining forms, reports, and logs via computerized management software. Your ability to be accurate and focus on attention to details...

Job SummaryAs a Coverage Specialist at Hub International, you will be responsible for analyzing insurance applications and determining coverage amounts and premiums. This is a full-time remote role that requires strong analytical skills and attention to detail.Key ResponsibilitiesAnalyze insurance applications to determine coverage amounts and...

About The Cancer & Hematology CentersThe Cancer & Hematology Centers is a leading independent community oncology practice dedicated to providing specialized care and access to the latest treatments and research trials in a compassionate environment. Our practice is committed to helping, healing, and hope for cancer patients and their families.Opportunity...