What are the responsibilities and job description for the Adjudication/Reimbursement Specialist position at Absolute Companies?
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Pharmacy technician certification must be obtained within 1 year of hire
Flexible scheduling β afternoon shift with rotating weekends
The responsibility of the Reimbursement specialist is to verify all patient information is accurate and billing information correct, allow all prescriptions to be billed to the correct payer source in regards to pricing, billing regulations and utilization guidelines.
Primary Duties and Responsibilities
Insurance Verifications
Address calls from facilities, guarantors and Insurance companies.
Initiate Prior Authorizations
Review Audits from Insurance companies
Reconciling online third party claims
Insurance Rejections from remittance
Medicaid Rejections from remittance
Other duties as assigned
Skill Requirements
Certification required within 1 year of hire date
Must be able to Multi-task
Excellent written and oral communication skills
Detail oriented
Self-motivated
Work well in team environment and independently
Basic Microsoft Word and Excel experience
A Reimbursement Specialist functions as an integral part of the team working towards a common goal : Customer Service, Quality and Employee Satisfaction