TELECOMMUTE – Columbus, OH
Title:Pharmacy Billing Adjudicator
Category:Pharmacy Technician|Billing & Collections|Omnicare
Job Type: Fully remote
As the Pharmacy Billing Adjudicator for our Long Term Care business, you will be responsible for preparing and submitting claims for accounts. You will work directly with nursing facility staff, physician offices, and insurance companies to ensure timely payment of online claim submissions. You will also be responsible for reviewing and researching rejected third party claims, and problem solving to take appropriate action to resolve them.
Additional key responsibilities include:
Making outbound calls to obtain patient information as needed
Collecting and processing patient billing information
Working a backlog of rejected claims for timely resubmission
Managing your assigned queues to keep current on all claims
Clearing the workflow grid daily in order to meet productivity criteria
Handling specific denials including new patient overrides
Following applicable government regulations (i.e. HIPAA)
To be successful in the role, we are seeking candidates who display the core values of CVS: Collaboration, Integrity, Caring, Innovation, and Accountability. You must be able to multi-task effectively, while working independently and as part of a team.
This role offers a comprehensive benefits package, including Medical, Dental, Vision, Flexible & Health Spending Accounts, paid Short Term Disability, and 401(k) with company match! In addition, you can expect up to 16 days of paid time off, 10 company paid holidays, and a colleague discount at our CVS Pharmacy stores!
You must be able to work a schedule of Monday through Friday, 9:30pm to 6:00 am Eastern Time, with rotating weekends and holidays.
This is a work from home opportunity.
6 months+ of medical/billing experience(Long Term Care or Pharmacy preferred) in a role with increasing responsibility and requiring the use of a computer, including beginner-moderate familiarity with Microsoft Excel and Access
Pharmacy Technician Certification experience is highly preferred
Pharmacy, Managed Care, Medicaid, and/or Medicare industry experience is preferred
High School Diploma or GED equivalent required
Customer Service , Insurance , Insurance Claims , Medical & Health , Medical Billing , Pharmaceutical