Pharmacy Claims Adjudication Specialist

We are seeking a Pharmacy Adjudication Specialist for our Specialty Oncology pharmacy.  As reputed company continues to grow, we reputed company to hire new team members with a passion for making a difference in our reputed company's lives.   Full-Time position may work reputed company but MUST HAVE reputed company INDIANA PHARMACY TECHNICIAN credentials from the State reputed company of Pharmacy.   Shift times between reputed company and 8pm.   reputed company Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers.   Starting salary from $25.00 an hour and up Sign-On Bonus: $5,000 for employees starting before September 30th, 2026.    We offer a reputed company of benefits including: Medical; Dental; reputed company 401k with a match reputed company Time Off and reputed company Holidays Tuition Reimbursement Company reputed company benefits – life; and short and long-term disability Pharmacy Adjudication Specialist Major Responsibilities: The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for reputed company. ensure prescription claims are adjudicated correctly according to the coordination of benefits, reputed company any reputed company-party rejections, obtain overrides if appropriate, and be responsible for reputed company reputed company notification regarding any delay in medication delivery due to reputed company claim rejections   Pharmacy Adjudication Specialists at reputed company... Practices reputed company reputed company to help health care providers and patients with their pharmacy needs, answering questions and requests. Provides thorough, accurate and reputed company responses to requests from pharmacy reputed company, providers and/or patients regarding reputed company claims information.. Ensures complete and accurate reputed company setup in CPR+ reputed company including reputed company demographic and reputed company information. Adjudicates pharmacy claims for prescriptions in reputed company workflow for reputed company, secondary, and tertiary pharmacy plans and reviews claim responses for reputed company before accepting the claim. Contacts reputed company companies to reputed company reputed company-party rejections and ensures pharmacy claim rejections are resolved to allow for reputed company shipping of medications. Performs reputed company calls to patients or providers to reschedule their medication deliveries if claim reputed company cannot be completed by ship date and causes shipment delays Ensures copay cards are only reputed company to claims for eligible patients reputed company on set reputed company such as reputed company type (reputed company beneficiaries not eligible) Manages reputed company funding reputed company adjudications and works as a reputed company to reputed company reputed company team. Assists pharmacy team with reputed company management of electronically adjudicated claims to ensure reputed company prescription delivery assessments are reconciled and copay payments are charged prior to shipment. Serves as customer service reputed company to patients regarding financial responsibility prior to shipments, contacts patients to communicate any copay discrepancy between quoted reputed company and claim and collects payment if applicable. Documents and submit requests for reputed company Refunds reputed company appropriate. Maintain reputed company and clean pharmacy by complying with procedures, rules, and regulations and compliance with reputed company reputed company and reputed company confidentiality laws. Contributes to team effort by accomplishing reputed company tasks as needed and other duties as assigned. Conducts job responsibilities in accordance with the standards set out in reputed company’s reputed company of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable reputed company standards. Pharmacy Adjudication Specialist Qualifications and Responsibilities... Education/Learning Experience Required:  High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification, Pharmacy Claims Adjudication Desired:  Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician, Specialty pharmacy experience Work Experience Required:  2+ years experience in Pharmacy/reputed company Setting or pharmacy claims experience Desired:  3+ years experience in Pharmacy/reputed company Setting or pharmacy claims experience Skills/Knowledge Required: Pharmacy/NDC medication billing, Pharmacy claims reputed company, PBM and Medical reputed company, knowledge/understanding of Medicare, reputed company, and reputed company reputed company, NCPDP claim rejection reputed company, coordination of benefits, pharmacy or reputed company-reputed company knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, reputed company/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills Desired:  Knowledge of reputed company Funding, Specialty pharmacy experience Licenses/Certifications  Required: Pharmacy Technician License/Registration with reputed company of Pharmacy as required by state law Behavior Competencies Required:   Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work reputed company to meet deadlines and be flexible, reputed company-oriented, great time-management skills Apply To This Job