Billing Adjudicator

Job ID: 552384BR
Business Area: CVS Health
Primary Location: NY ‒ Plainview
Job Type: Full Time
Job Category: Billing & Collections
Clinical Licensure Required: N/A
Location Code OF509
Position Summary:
Omnicare,Inc. is a wholly owned subsidiary of CVS Health Corporation. www.cvshealth.com

What We Do

Directly, and through our subsidiaries, Omnicare provides a broad array of pharmacy-related services to long term care facilities and to other customers in the health care environment. While senior care has long been an Omnicare specialty, we also serve other targeted populations.


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.


Monday through Friday 2:30pm to 11pm with rotating weekends.

  • Review and research rejected Third-Party claims taking appropriate action to resolve.
  • Work backlog of denied claims for timely re-submission.
  • Manage assigned queues keeping up-to-date and current on all claims.
  • Workflow 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


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 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

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 AA EEO CVS Health

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/
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