Job Summary
The Pharmacy Adjudication Specialist plays a crucial role in the pharmacy sector by managing the adjudication process for pharmacy claims. This position involves resolving issues related to third-party rejections and ensuring correct coordination of benefits. Additionally, the Specialist is tasked with reaching out to patients about delays in medication delivery and handling communications regarding financial responsibilities.
Responsibilities
- Oversee the adjudication process for pharmacy claims.
- Resolve third-party payment rejections effectively.
- Ensure accurate coordination of benefits for patients.
- Conduct outreach to patients concerning medication delivery issues.
- Manage communications regarding patients’ financial responsibilities.
Qualifications
- High School Diploma or GED.
- A minimum of 2 years’ experience in a pharmacy or healthcare environment.
- Proficient in pharmacy claims resolution and knowledgeable about insurance processes.
- Strong analytical skills and effective communication abilities.
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.
