Adjudication Associate (Omnicare) - Overnight

Adjudication Associate (Omnicare)

We're building a world of health around every individual shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger helping to simplify health care one person, one family and one community at a time.

The Adjudication Associate (Omnicare) is responsible for the preparation and submission of claims for accounts to ensure timely reimbursements. This person will communicate with the nursing facility staff, physician offices, and insurance companies to maintain payment deliverables for online claim submissions.

Responsibilities:

• Follows established procedures to execute routine business support tasks for the Adjudication Omnicare function under general supervision.
• Develops effective relationships with all team members to ensure daily communication to resolve issues and prevent delays in service.
• Conducts review and research of rejected claims and takes action for resolution.
• Handles work backlog of denied claims for timely resubmission.
• Ensures compliance with all government and regulatory requirements.
• Takes direction to execute techniques, processes, and responsibilities.

Required Qualifications

• 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, as well as be willing to work weekends (once every three weeks) and holidays (several times per year).

Preferred Qualifications

• Pharmacy technician certification.
• Previous experience in managed care and Medicaid and/or Medicare organizations.
• 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.

Education

• High school diploma or GED.

Anticipated Weekly Hours: 40

Time Type: Full time

Pay Range: $17.00 - $34.15

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full?time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well?being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.