Adjudication Associate – Overnight
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Job Description
Adjudication Associate preparing and resubmitting pharmacy claims for Omnicare’s long-term care facilities. Reviewing denials and coordinating with facilities, providers, and insurers overnight.
Responsibilities:
- Prepare and submit claims for accounts to ensure timely reimbursements
- Communicate with nursing facility staff, physician offices, and insurance companies to maintain payment deliverables for online claim submissions
- Execute routine business support tasks for the Adjudication Omnicare function under general supervision
- Develop effective relationships with team members to ensure daily communication, resolve issues, and prevent service delays
- Review and research rejected claims and take action for resolution
- Handle backlog of denied claims for timely resubmission
- Ensure compliance with government and regulatory requirements
- Follow direction to execute techniques, processes, and responsibilities
Requirements:
- At least 1 year of experience in a pharmacy-based setting
- At least 1 year of experience in customer service
- Basic proficiency with desktop software applications, particularly Microsoft Excel and Microsoft Access
- Must be able to work Monday-Friday from 9:00pm-5:30am Eastern Standard Time
- Willingness to work weekends once every three weeks
- Willingness to work holidays several times per year
- High school diploma or GED
- Pharmacy technician certification preferred
- Previous experience in managed care and Medicaid and/or Medicare organizations preferred
- Ability to perform multiple tasks effectively
- Ability to work both independently and as part of a team
- Ability to operate independently
- Dedicated and reliable nature
Benefits:
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being
- Full-time position with comprehensive benefits package
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