Claims processing jobs in New York, NYCreate job alerts

Elm Drugs is an independently owned and operated pharmacy located on the border of the West Village and Chelsea in Manhattan. We have been proudly serving our customers and patients since 2010 and pride ourselves on the level of personalized care we deliver to them on a daily basis. We are seeking a full-time Staff Pharmacist to join our team. **WE OFFER 3 OR 4 DAY WORK WEEKS, HEALTH INSURANCE FOR ELIGIBLE NEW HIRES, GENEROUS EMPLOYEE DISCOUNT, PAID TIME OFF AND A GREAT WORK ENVIRONMENT** JOB DESCRIPTION Staff Pharmacist Full-Time As a Staff Pharmacist, you will perform all duties of a pharmacist under the supervision and guidance of the Supervising Pharmacist. JOB RESPONSIBILITIES/TASKS - Provide an excellent customer experience for our customers and patients - Engage customers and patients by greeting them and offering assistance with products and services. Resolve customer issues in a timely manner and answer questions to ensure a positive customer experience. - Counsel patients and answer their questions regarding usage of medicine, side effects, interactions, contraindications, patient information privacy, generics, less expensive medicines, over-the-counter products, and refer to medical provider as needed to ensure medication is taken correctly, health needs addressed, and satisfaction with service. - Perform pharmacist tasks including drug therapy reviews, verification, and medication management. Review, interpret and accurately dispense prescribed medications when necessitated by workload. - Ensure the pharmacy operates in accordance to regulations, company policies and standards. Responsible for the opening and closing of the pharmacy and shift change duties. - Ensure the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follow-up with insurance companies as well as medical providers and participates in 3rd party audit. - Follow-up with medical providers’ offices to clarify prescribed medications, dosages, refills, interactions and allergies to suggest alternative medications, and answer medical provider questions. - Perform retail, clinical, and wellness services such as immunizations, flu shots, diabetes awareness and other preventive healthcare services. - Develop and maintain good relationships with local medical community including physicians, nurses, and other health care providers. Participate in community outreach activities to promote the pharmacy business and further enhance growth opportunities. - Training & Personal Development - Maintain current knowledge and skills related to pharmacy and healthcare by reading pharmacy related journals, and communications. Maintain awareness of developments in retail and pursue best practices that would enhance performance. COMPENSATION The typical pay range for this role is: Minimum: $ 60.00 and up Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors. MINIMUM REQUIRED QUALIFICATIONS · Active Pharmacy License in the state of New York · Not on the DEA Excluded Parties List · Immunization Certification through an accredited organization · No pending felony charges or convictions for criminal offenses involving controlled substances EDUCATION Bachelor of Science in Pharmacy or Pharm. D. degree

*This role is for our subsidiary company, Class Action Capital. Class Action Capital is a boutique class action claims management firm in the global litigation finance industry specializing in the identification, research, data analysis and filing of complex class action claims for corporate clients. CAC is seeking a highly motivated and detail-oriented Vice President of Finance to manage our day-to-day financial operations and the receipt and distribution of class action funds to our corporate clients. The ideal candidate possesses a solid foundation in accounting and financial principles and a passion for driving financial efficiency and accuracy. This role will provide accounting and financial leadership, financial asset protection and support strategic and investment operating initiatives. Responsibilities: - Oversee and manage the accounting and financial departments, ensuring accurate and timely financial reporting. - Develop and maintain internal control systems to safeguard company assets and ensure compliance with financial policies and procedures, including our multi-national presence. - Develop and implement efficient processes for receiving and distributing settlement funds to our corporate clients in cooperation with our corporate banking partner. - Oversee entry and maintenance of financial information and verifying reliability and accuracy. - Ensure compliance with all legal, tax and regulatory requirements. - Prepare monthly, quarterly, and annual financial statements and reports. - Manage the budgeting and forecasting process, working closely with department heads to develop accurate financial projections. - Collaborate with external accountants and manage the accounting and tax process. - Provide financial analysis and insights to support decision-making and performance improvement initiatives. - Create and coordinate financial dashboards in cooperation with executive leadership. Requirements: - Bachelors degree in Accounting, Finance, or a related field. - CPA is required. - Minimum of 5 years of experience in accounting or financial management, with at least 2 years in a supervisory role. Professional services market experience preferred. - Strong knowledge of GAAP, financial regulations, and internal control best practices. - Excellent organizational and time management skills, with the ability to prioritize tasks and meet deadlines. - Experience in Netsuite and proficiency in Microsoft Excel. - Excellent communication and interpersonal skills, with the ability to collaborate effectively with cross-functional departments. - Proven ability to work independently with minimal oversight and direction. - Demonstrated problem-solving skills and attention to detail. Benefits - Base Salary: $175,000 - $225,000. We, in good faith, believe this pay range to be accurate at the time of positing but may decide to pay more or less depending on specific applicants qualifications and experience. This pay range is only applicable to New York City. - Performance Based Annual Bonus - Health Care Plan (Medical, Dental & Vision) - 401K - Paid Time Off (Vacation, Sick & Public Holidays) - Hybrid Workforce

Prescription Processing: Receive and verify prescriptions from doctors or patients. Accurately interpret prescription orders, including medication dosage, strength, and directions. Prepare and label medications according to prescription orders. Ensure the correct drug, dosage, and instructions are provided. Medication Dispensing: Assist in the preparation of medication by counting, measuring, and mixing medications. Dispense prescribed medications to patients. Ensure the right medication is provided to the right patient. Inventory Management: Monitor and maintain inventory levels of medications and supplies. Order and stock medications as necessary. Check for expired medications and ensure proper disposal when required. Customer Service: Provide excellent customer service by answering patient inquiries and addressing concerns. Explain proper medication usage, dosage, and potential side effects to patients. Assist patients in understanding prescription refills, insurance matters, or general pharmacy policies. Medication Preparation and Compounding: Prepare customized medications (e.g., creams, ointments, solutions) when required. Follow strict guidelines for compounding sterile and non-sterile medications. Record Keeping and Documentation: Maintain accurate and up-to-date patient medication records. Document prescription orders, refills, and patient consultations. Ensure confidentiality of patient information according to HIPAA regulations. Quality Control: Double-check prescriptions for accuracy and completeness. Ensure medications are properly stored, following safety protocols. Participate in routine audits or checks to maintain compliance with legal and regulatory standards. Collaboration with Pharmacists and Healthcare Professionals: Work under the supervision of licensed pharmacists to ensure proper patient care. Communicate with doctors or other healthcare professionals regarding prescription clarifications or medication interactions. Insurance and Billing: Process insurance claims and verify patient insurance information. Assist patients in understanding prescription coverage and any out-of-pocket costs. Maintaining Pharmacy Equipment: Ensure all pharmacy equipment is functioning properly, including pill counters, label printers, and compounding tools. Pharmacy technicians play an essential role in supporting pharmacists and ensuring that patients receive the correct medication and care.

We're looking for a Contract Customer Service Representative to join our team and support our members exceptionally. This role involves engaging with Garner members via phone, chat, and email to help them find the right healthcare for their needs, understand how our program works, and get their eligible claims paid. We seek detail-oriented individuals with strong written and verbal communication skills who can stay organized, handle complex situations, and maintain professionalism in every interaction. The ideal candidate will demonstrate a passion for helping others, an ability to de-escalate challenging situations, and a clear commitment to providing the best service possible. Key Requirements: Applicants must be located within the United States and must work in the United States for the duration of their employment. International applicants will not be considered. Excellent written and verbal communication skills: You must express yourself clearly and professionally, especially in written communication (emails, chat), with no grammatical or spelling errors. We value clear, concise writing. De-escalation skills: You must handle tense or difficult situations with empathy and patience. We want candidates who are comfortable managing escalations and who can demonstrate problem-solving abilities in these contexts Attention to detail: We are looking for candidates who can accurately follow instructions, pay close attention to member inquiries, and ensure solutions are clear and correct. Responsibilities: Deliver exceptional service to our members via phone, chat, and email, offering education, guidance, and healthcare benefits and claims assistance. Follow best practices for handling member inquiries and proactively suggest process improvements when identified. De-escalate member concerns with empathy and professionalism, providing effective and accurate solutions. Maintain a high level of accuracy in all written communication; ensure grammar, spelling, and punctuation are always correct. Attention to detail is critical: accurately capture member information, follow up on requests, and keep clear records of interactions. Send us your resume, we pick the best candidates randomly

NYC OPTICAL is a leading provider of comprehensive eye care services dedicated to improving our patients' vision and overall eye health. Our team of experienced professionals offers personalized care with a commitment to excellence. We are currently seeking a detail-oriented Insurance Payment Data Entry Specialist to join our dynamic administrative team. Job Overview: The Insurance Payment Data Entry Specialist will be responsible for accurately entering and managing insurance payment data within our billing system. This role involves handling various aspects of insurance claim processing, patient account management, and ensuring timely and accurate payment processing. Key Responsibilities: Enter and maintain accurate insurance payment information in the clinic’s billing system. Verify patient insurance details and payment amounts to ensure accuracy. Assist with the preparation, submission, and follow-up of insurance claims. Resolve discrepancies and address issues related to insurance payments and claims. Communicate effectively with insurance companies, patients, and clinic staff to facilitate smooth payment processing. Maintain organized and up-to-date records of all transactions and communications related to insurance payments. Ensure compliance with relevant regulations and standards. Qualifications High school diploma or equivalent; associate’s or bachelor’s degree in a related field is a plus. Previous experience in insurance payment processing, data entry, or a similar role preferred. Strong attention to detail and accuracy in data entry. Proficiency in medical billing software and Microsoft Office Suite (Excel, Word). Excellent organizational and time-management skills. Strong communication skills and the ability to work effectively. Knowledge of medical terminology and insurance procedures is an advantage. NYC Optical is an equal-opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Job Types: Full-time, Temp-to-hire Pay: $17.00 - $21.01 per hour Expected hours: 40 per week Benefits: Employee discount Flexible schedule Paid time off Vision insurance Schedule: 8 hour shift Monday to Friday No weekends Experience: Microsoft Excel: 1 year (Required) Ability to Commute: Brooklyn, NY 11239 (Required) Ability to Relocate: Brooklyn, NY 11239: Relocate before starting work (Required) Work Location: In person