Pharmacy Technician: Claims Adjudication Specialist

Job summary
Claims Adjudication Specialist positionProblem-solving and working with insurance companiesJoin a company that values its employees
Job seniority: entry level
Responsibilities
• 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 solve insurance issues• Communicate with internal staff regarding claims rejections and Refill too soon outcomes• Assist with DME claims adjudication
Requirements
• 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• Reliability and solid work history considered• Completed pre-employment drug screen and background check required
Benefits
• Health Insurance• Dental Insurance• Vision Insurance• Disability Insurance• PTO• 401(K) & Match• Work/Life Balance• Opportunity for Continuing Education