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Pharmacy Billing Adjudicator

at CVS Health

Posted: 11/20/2019
Job Reference #: 1124397BR
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Job Description

Job Description
Omnicare,Inc. is a wholly owned subsidiary of CVS Health Omnicare, Inc. is a wholly owned subsidiary of CVS Health Corporation. www.cvshealth.com

What We Do

Directly, and through our subsidiaries, Omnicare provides a broad array of pharmacy-related services to long term care facilities and to other customers in the health care environment. While senior care has long been an Omnicare specialty, we also serve other targeted populations.

Primary Responsibilities
In this role you will
-Review and research rejected Third-Party claims taking appropriate action to resolve.
-Work backlog of denied claims for timely resubmission.
-Manage assigned queues keeping up-to-date and current on all claims.
-Workflow grid is cleared daily meet productivity criteria
-Specific denials including new patient overrides
-Follow all applicable government regulations including HIPAA.
-Display behavior which exemplifies the Core Values.
-Other duties as deemed necessary

The shift schedule is 12:30 am-9 am Thursday-Monday. Rotating holidays.

Required Qualifications
-Entry-Level familiarity with Excel/Access
-Perform multiple tasks effectively
-Ability to work both independently and as part of a team

Preferred Qualifications
-Pharmacy technician certification (highly preferred)
-Experience in pharmacy, managed care, Medicaid and/or Medicare organizations

Education
High School Diploma or equivalent

Business Overview
It’s a new day in health care.

Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation’s premier health innovation company. Through our health services, insurance plans and community pharmacists, we’re pioneering a bold new approach to total health. As a CVS Health colleague, you’ll be at the center of it all.

We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.

CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran - we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team. Please note that we only accept applications for employment via this site.

If technical issues are preventing you from applying to a position, contact Kenexa Helpdesk at 1-855-338-5609 or cvshealthsupport@us.ibm.com. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!