Job Summary
The Pharmacy Adjudication Specialist plays a key role in processing pharmacy claims, addressing third-party rejections, and facilitating precise coordination of benefits. In this capacity, the specialist acts as a communication link between patients and healthcare providers concerning financial obligations and the scheduling of medication deliveries.
Responsibilities
- Manage the adjudication process for pharmacy claims.
- Resolve rejections from third-party payers.
- Ensure accurate and efficient coordination of benefits.
- Communicate with patients and providers regarding financial responsibilities.
- Oversee the scheduling of medication deliveries.
Qualifications
- A high school diploma or GED is required.
- Minimum of 2 years of experience in a pharmacy or healthcare environment.
- Expertise in resolving pharmacy claims and familiarity with insurance processes.
- Strong analytical abilities are essential.
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.
