The Adjudication Associate (Omnicare) is responsible for the preparation and submission of claims for accounts to ensure timely reimbursements. This person will communicate with the nursing facility staff, physician offices, and insurance companies to maintain payment deliverables for online claim submissions.

Responsibilities:

• Follows established procedures to execute routine business support tasks for the Adjudication Omnicare function under general supervision.

• Develops effective relationships with all team members to ensure daily communication to resolve issues and prevent delays in service.

• Conducts review and research of rejected claims and takes action for resolution.

• Handles work backlog of denied claims for timely resubmission.

• Ensures compliance with all government and regulatory requirements.

• Takes direction to execute techniques, processes, and responsibilities.

Required Qualifications

• At least 1 year of experience in customer service.

• Basic proficiency with desktop software applications, particularly Microsoft Excel and Microsoft Access.

• Must be able to work Monday-Friday from 9:00pm-5:30am Eastern Standard Time, as well as be willing to work weekends (rotating regularly) and holidays (several times per year).

Preferred Qualifications

• Pharmacy technician certification.

• Previous experience in managed care and Medicaid and/or Medicare organizations.

• Ability to perform multiple tasks effectively.

• Ability to work both independently and as part of a team.

• Ability to operate independently.

• Dedicated and reliable nature.

Education

• High school diploma or GED.