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Billing Adjudicator

Job Description
Omnicare, Inc. is a wholly ownedsubsidiary of CVS Health Corporation. www.cvshealth.com

What We Do

Directly, and through oursubsidiaries, Omnicare provides a broad array of pharmacy-related services tolong term care facilities and to other customers in the health careenvironment. While senior care has long been an Omnicare specialty, we alsoserve other targeted populations.

Overview : A billing adjudicator is responsible for preparing and submitting claims for accounts and works with nursing facility staff, physician offices, and insurance companies to ensure timely payment of online submission of claims.

Primary Responsibilities

-Review and research rejected Third Party claims taking appropriate action to resolve.
-Work back log of denied claim for timely re-submission
-Manage assigned queues keeping up to date and current on all claims
-Work flow grid is cleared daily, meet productivity criteria.
-Specific denials including new patient overrides
-Follow all applicable government regulations including HIPAA
-Display behavior which exemplifies the Core Values Other duties as deemed necessary.


Required Qualifications
-Entry Level Familiarity with Excel/Access
-Perform multiple tasks effectively
-Able to work both independently and as part of a team


Preferred Qualifications
-Pharmacy technician certification highly preferred
-Experience in pharmacy, managed care, Medicaid and or Medicare organizations


Education
High School Diploma or equivalent


Business Overview
CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.

CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking EEO AA CVS Health

CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.

For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/