Adjudication Associate – Overnight

Job not on LinkedIn

🔥 3 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $17 - $34 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Prepare and submit claims for accounts to ensure timely reimbursements • Communicate with nursing facility staff, physician offices, and insurance companies to maintain payment deliverables for online claim submissions • Execute routine business support tasks for the Adjudication Omnicare function under general supervision • Develop effective relationships with team members to ensure daily communication, resolve issues, and prevent service delays • Review and research rejected claims and take action for resolution • Handle backlog of denied claims for timely resubmission • Ensure compliance with government and regulatory requirements • Execute techniques, processes, and responsibilities as directed

🎯 Requirements

• At least 1 year of experience in a pharmacy-based setting • 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 • Willingness to work weekends once every three weeks • Willingness to work holidays several times per year • High school diploma or GED • Pharmacy technician certification preferred • Previous experience in managed care and Medicaid and/or Medicare organizations preferred • Ability to perform multiple tasks effectively • Ability to work both independently and as part of a team • Ability to operate independently

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being, based on eligibility