Billing Adjudicator

Position Summary:
Omnicare, Inc. is a wholly owned subsidiary of CVS Health Corporation.

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 healthcare environment. While senior care has long been an Omnicare specialty, we also serve other targeted populations.

Overview: As Billing Adjudicator, you are responsible for preparing and submitting claims for accounts and works with nursing facility staff, physician offices, and insurance companies to ensure timely payment of online submission of claims.

Shift: Overnight Monday through Friday 9:30pm to 6am, including some weekends and holidays

Primary Responsibilities:
In this role
You review and research rejected Third-Party claims taking appropriate action to resolve.
You work backlog of denied claims for timely resubmission.
You manage assigned queues keeping up-to-date and current on all claims.
You ensure the workflow grid is cleared daily; you meet productivity criteria
Specific denials including new patient overrides
You follow all applicable government regulations including HIPAA.
You display behavior which exemplifies the Core Values.
Other duties as deemed necessary

Physical Demands:
The physical demands of this job may require
You to be sitting, stand, stoop, bend and walk intermittently during the day.
Standing and sitting may be for seven (7) to ten (10) hours per day.
You to work extended hours as needed.
You are required to have finger dexterity to operate office equipment
You to lift up to twenty-five (25) pounds on occasion.
You Possess visual acuity to see and read fine prints.
You meet specific vision abilities required by this role include close vision, color vision and the ability to adjust focus.
You are able to hear normal voice sounds.
You to travel for business as necessary.
You will work in a climate-controlled, smoke-free internal environment.

Required Qualifications:
-You have earned a high school diploma or its equivalent
-You have an entry level experience and skill level of Excel/Access
-You perform tasks both efficiently and effectively
-You are able and enjoy working independently, as well as collaboratively

Preferred Qualifications:
-You are Pharmacy technician certification (highly preferred)
-Your experience includes pharmacy, managed care, Medicaid and/or Medicare organizations

High school diploma or equivalent

Business Overview:
CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.

CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, 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

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking EEO AA CVS Health

CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.

For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website:

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