Adjudication Associate – Overnight

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🔥 0 minutes ago

🦞 Maine – Remote

🦞 Maine – Remote

💵 $17 - $42 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

Healthcare Insurance • Retail • Wellness

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

• responsible for the preparation and submission of claims for accounts to ensure timely reimbursements. • communicate with the nursing facility staff, physician offices, and insurance companies to maintain payment deliverables for online claim submissions. • follow established procedures to execute routine business support tasks for the Adjudication Omnicare function under general supervision. • develop effective relationships with all team members to ensure daily communication to resolve issues and prevent delays in service. • conduct review and research of rejected claims and take action for resolution. • handle work backlog of denied claims for timely resubmission. • ensure compliance with all government and regulatory requirements. • take direction to execute techniques, processes, and responsibilities.

🎯 Requirements

• At least 1 year of experience in a pharmacy-based environment. • 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 (once every three weeks) and holidays (several times per year).

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • other resources, based on eligibility