Job Summary
The Pharmacy Adjudication Specialist plays a crucial role in processing pharmacy claims, addressing any third-party rejections, and facilitating proper coordination of benefits. This position is also pivotal in acting as a bridge between patients and healthcare providers, particularly concerning financial obligations and medication delivery timelines.
Responsibilities
- Process and adjudicate pharmacy claims efficiently.
- Resolve issues related to third-party rejections of claims.
- Ensure effective coordination of benefits for patients.
- Serve as a point of contact for patients and providers regarding financial responsibilities.
- Manage medication delivery schedules and communicate relevant information.
Qualifications
- High School Diploma or GED is required.
- A minimum of 2 years of experience in a pharmacy or healthcare environment is necessary.
- Strong understanding of pharmacy claims resolution and insurance processes.
- Excellent analytical skills to assess and resolve claims issues.
Onco360 provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
