Pharmacy Adjudicator
4 months ago
**CareOne Pharmacy is looking for a full time pharmacy biller/adjudicator**
- Long term care pharmacy billing experience preferred
- Must be able to efficiently and accurately resolve insurance claim rejections
- Ability to read and interpret written prescriptions and medical data
- Acts as a resource to the facilities in obtaining information, completing necessary documentation, and following up on outstanding claims
- Understands Insurance and Medicare/Medicaid formularies and processes, including the prior authorization processes
- Able to make outgoing calls to insurance companies, facilities, and Physician’s offices as needed to obtain approvals
- Pleasant on the phone
- Able to call insurance companies and solve billing issues
- Frameworks experience is a plus
- Long term care experience is a plus
- Pharmacy Tech experience is a plus
- Brand/Generic drug knowledge preferred
- Prioritizes work to meet daily and competing deadlines.
- **Performs other tasks as assigned**
**Minimum Qualifications**:
- Minimum 1 year of experience in pharmacy setting
- Long-Term Care experience preferred
- Basic understanding of drugs, SIG codes, and metric system; ability to communicate effectively; skilled in operating a computer; skilled in performing detailed work required
Pay: $16.00 - $19.00 per hour
**Benefits**:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Schedule:
- Monday to Friday
- Weekends as needed
Application Question(s):
- What is your expected salary requirement?
- Do you have any scheduling conflicts?
**Experience**:
- billing: 1 year (preferred)
License/Certification:
- Pharmacy Technician License (preferred)
Shift availability:
- Night Shift (preferred)
Work Location: In person