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Pharmacy Technician: Claims Adjudication Specialist

5 months ago

Gretna, United States CONSONUS PHARMACY SERVICES Full time

Do you like to problem solve and can’t stop until you figure it out?  Does working with insurance companies make your day? Want to find a company that values their employees? A company that REALLY values them Looking to find a company you’ll be proud to be a part of?  Ever had a position that involved patient billing or adjudicating accounts? If you answered yes, then we want to meet you Our long-term care pharmacy is looking to add only exceptional people to our team.

What will a Claims Adjudication Specialist do every day?  

  • Process Medicare, Medicaid, Hospice and Insurance claims for payment
  • Interpret claims rejections and insurance denial
  •  Contact Insurance and Hospice plans for clarification and overrides
  • Train to be an expert in pharmacy benefits to problem solve and resolve insurance issues
  • Communicate with internal staff regarding claims rejections and Refill too soon out comes 
  • Assist with DME claims adjudication

Claims Adjudication Specialist minimum requirements will include:

 High School Diploma, or equivalent 

  • Pharmacy Technician License and National Certification required 
  • 1-year coding and insurance processing experience preferred
  • 1-year word processing and/or data entry experience required
  • 1-year customer service experience required
  • Knowledge of Medicare, Medicaid, coding and insurance processing a plus but will train 
  • Knowledge of DME claims processing a plus but will train
  • Strong written and oral communication skills required
  • Strong organizational and analytical skills required
  •  Must be able to actively contribute to a positive team environment Must be a self-starter with the ability to handle multiple tasks, remain focused, and work independently
  •  Must be detail oriented, and able to thrive in a fast-paced environment 
  • Only an individual who is reliable and have a solid work history will be seriously considered for the position.  A completed pre-employment drug screen and background check will be conducted.
  • This hourly position requires a schedule of Monday thru Friday with a rotating schedule between the hours of 7am to 6:30pm, with rotating weekend shifts.  Flexibility is a must for rotating weekday and weekend shifts.   

Benefits:

  • Health Insurance
  • Dental Insurance
  • Vision Insurance
  • Disability Insurance
  • PTO
  • 401(K) & Match
  • Work/Life Balance
  • Opportunity for Continuing Education 

“Be here. Be you.”

For more than 30 years, Marquis Companies and Consonus Healthcare have been serving seniors and welcoming staff of all backgrounds, skills, and perspectives. The Marquis family of companies offer a rich heritage of embracing differences and honoring individuality. We’ve continued to grow in our appreciation of diversity in the workplace. We know it builds strength, drives innovation, and brings valuable new perspectives and energy.

We’re committed to making our workforce an even greater reflection of the people and communities we serve, and we are honored our employees have chosen to work at Marquis and Consonus. Everything we do as a company is driven by our mission to help those we serve, and each other, live the best rest of our lives.

That means you being you – without apology or compromise. We value your every uniqueness and continue to curate, nurture, and sustain an inclusive culture. It’s the foundation of who we are and the evolution of our collective future.

Consonus Pharmacy is an Equal Opportunity Employer