Current jobs related to Pharmacy Adjudication Specialist - Woodridge - Onco360
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Pharmacy Adjudication Specialist
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Woodridge, Illinois, United States Onco360 Full timeJob Title: Pharmacy Adjudication SpecialistAt Onco360, we are seeking a highly skilled Pharmacy Adjudication Specialist to join our team. As a Pharmacy Adjudication Specialist, you will play a critical role in ensuring the accurate and timely adjudication of pharmacy claims.Key Responsibilities:Adjudicate pharmacy claims for prescriptions in active workflow...
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Woodridge, Illinois, United States Onco360 Full timePharmacy Adjudication SpecialistWe are seeking a highly skilled Pharmacy Adjudication Specialist to join our team at Onco360 Pharmacy. As a Pharmacy Adjudication Specialist, you will be responsible for adjudicating pharmacy claims, reviewing claim responses for accuracy, and ensuring prescription claims are adjudicated correctly according to the coordination...
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Pharmacy Claims Adjudication Specialist
4 days ago
Woodridge, Illinois, United States Onco360 Full timeAbout the Role:We are seeking a highly skilled Pharmacy Adjudication Specialist to join our team at Onco360 Pharmacy. As a Pharmacy Adjudication Specialist, you will be responsible for adjudicating pharmacy claims, reviewing claim responses for accuracy, and ensuring prescription claims are adjudicated correctly according to the coordination of benefits.Key...
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Pharmacy Claims Specialist
1 month ago
Woodridge, Illinois, United States Onco360 Full timePharmacy Adjudication SpecialistWe are seeking a highly skilled Pharmacy Adjudication Specialist to join our team at Onco360 Pharmacy in Woodridge, IL. This is a full-time position with two available shifts: Monday to Friday, 10:30am to 7pm CST or 8:30am to 5pm CST. The ideal candidate will be located within driving distance to our pharmacy and have a hybrid...
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Pharmacy Claims Specialist
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Woodridge, Illinois, United States Onco360 Full timeJob Title: Pharmacy Adjudication SpecialistWe are seeking a highly skilled Pharmacy Adjudication Specialist to join our team at Onco360 Pharmacy in Woodridge, IL. This is a full-time position, Monday to Friday, 10:30am to 7pm CST.Job Summary:The Pharmacy Adjudication Specialist will be responsible for adjudicating pharmacy claims, reviewing claim responses...
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Lead Pharmacy Billing Team Manager
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Woodridge, Illinois, United States Symbria Full timeJob SummarySymbria is seeking a highly skilled Lead Pharmacy Billing Technician to oversee daily operations of an assigned billing team. This key role involves developing a thorough understanding of skilled nursing admission processes and required documentation to guide the team's efforts in executing timely billing.The ideal candidate will have a strong...
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Pharmacy Benefit Verification Specialist
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Pharmacy Prior Authorization Specialist
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Pharmacy Prior Authorization Specialist
1 week ago
Woodridge, Illinois, United States Onco360 Full timePharmacy Prior Authorization SpecialistWe are seeking a highly skilled Pharmacy Prior Authorization Specialist to join our team at Onco360 Pharmacy. As a Pharmacy Prior Authorization Specialist, you will play a critical role in ensuring that patients receive the medication they need by managing prior authorizations with insurance carriers.Key...
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Lead Pharmacy Billing Technician
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Woodridge, United States Symbria Full timeOverview Symbria Rx Services is seeking a Lead Pharmacy Billing Technician to add to our growing team. The Lead Pharmacy Billing Technician is responsible for the oversight of an assigned team of billers.The Lead Pharmacy Billing Technician will also be responsible for performing certain billing functions. Check out our video about Symbria and how you...
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Pharmacy Technician
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Pharmacy Prior Authorization Specialist
4 days ago
Woodridge, Illinois, United States Onco360 Full timeWe are seeking a highly skilled Pharmacy Prior Authorization Specialist to join our team at Onco360 Pharmacy. The ideal candidate will have excellent communication skills, be detail-oriented, and have a strong understanding of pharmacy insurance claims and prior authorization processes.The Pharmacy Prior Authorization Specialist will be responsible for...
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Pharmacy Technician
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Woodridge, Illinois, United States Symbria Full timeJob Summary:Symbria Rx Services is seeking a highly skilled Pharmacy Technician to join our team at our Pharmacy located in Woodridge, IL. As a Pharmacy Technician, you will play a crucial role in assisting pharmacists in the preparation of medications for distribution to Long-Term Care (LTC) communities.Key Responsibilities:Assist pharmacists on duty in...
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Pharmacy Technician
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Woodridge, Illinois, United States Symbria Full timeJob Summary:Symbria Rx Services is seeking a skilled Pharmacy Technician to join our team at our Pharmacy located in Woodridge, IL. As a Pharmacy Technician, you will assist the pharmacist in the preparation of medications for distribution to Long-Term Care (LTC) communities.Key Responsibilities:Assist the pharmacist(s) on duty in preparing medications for...
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Pharmacy Technician
3 days ago
Woodridge, Illinois, United States Symbria Full timeJob SummarySymbria is seeking a highly skilled Pharmacy Technician to join our team at our pharmacy located in Woodridge, IL. As a Pharmacy Technician, you will play a crucial role in assisting pharmacists in the preparation of medications for distribution to Long-Term Care (LTC) communities.Key Responsibilities:Assist pharmacists in filling orders...
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Inventory Specialist
3 days ago
Woodridge, Illinois, United States Symbria Full timePurchasing and Inventory Specialist Job SummaryThe Purchasing and Inventory Specialist will partner with the Purchasing and Inventory Supervisor to manage the activities of the purchasing and inventory control departments of all Symbria Rx Service's pharmacies in a cost-effective manner. This includes ensuring the maintenance of records concerned with...
Pharmacy Adjudication Specialist
2 months ago
We are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy in Woodridge, IL. This will be a Full-Time position. There are 2 shifts available: Monday to Friday, 10:30 am to 7 pm CST or 8:30 am to 5 pm CST. This position must be located within driving distance to our pharmacy, with a hybrid work style. Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers. Starting salary from $20.00 an hour and up We offer a variety of benefits including: Medical; Dental; Vision 401k with a match Paid Time Off and Paid Holidays Tuition Reimbursement Company paid benefits – life; and short and long-term disability Pharmacy Adjudication Specialist Major Responsibilities: The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy, ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections. Pharmacy Adjudication Specialists at Onco360: Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests. Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding active claims information. Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information. Adjudicates pharmacy claims for prescriptions in active workflow for primary, secondary, and tertiary pharmacy plans and reviews claim responses for accuracy before accepting the claim. Contacts insurance companies to resolve third-party rejections and ensures pharmacy claim rejections are resolved to allow for timely shipping of medications. Performs outreach calls to patients or providers to reschedule their medication deliveries if claim resolution cannot be completed by ship date and causes shipment delays. Ensures copay cards are only applied to claims for eligible patients based on set criteria such as insurance type (Government beneficiaries not eligible). Manages all funding related adjudications and works as a liaison to Onco360 Advocate team. Assists pharmacy team with all management of electronically adjudicated claims to ensure all prescription delivery assessments are reconciled and copay payments are charged prior to shipment. Serves as customer service liaison to patients regarding financial responsibility prior to shipments, contacts patients to communicate any copay discrepancy between quoted amount and claim and collects payment if applicable. Documents and submits requests for Patient Refunds when appropriate. Pharmacy Adjudication Specialist Qualifications And Responsibilities: Education/Learning Experience Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification, Pharmacy Claims Adjudication. Desired: Associate degree or equivalent program from a 2-year program or technical school, Certified Pharmacy Technician, Specialty pharmacy experience. Work Experience Required: 1+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience. Desired: 3+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience. Skills/Knowledge Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills. Desired: Knowledge of Foundation Funding, Specialty pharmacy experience. Licenses/Certifications Required: Registration with Board of Pharmacy as required by state law. Desired: Certified Pharmacy Technician (PTCB). Behavior Competencies Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skills. #J-18808-Ljbffr
