What are the responsibilities and job description for the Pharmacy Adjudication Technician position at Pharmacy Solutions Group - Ohio?
Pharmacy Adjudication Technician
Pharmacy Solutions Group is currently recruiting an Adjudication Technician to join our Ohio team!
Responsibilities :
- Responsible for adjudication of daily unit dose and non-unit dose claims
- Contacting insurance for proper overrides
- New Admits for assigned homes (MOP, group codes, tax group, addresses, invoice group, customer group, allergies, MRN, MEDA Days, Per Diem Days when applicable)
- Contacting families on new admits ensuring we have the proper method of payment established when no insurance found or address issues.
- Running New Admit Report on a weekly basis auditing admits for (MOP, group codes, tax Group, addresses, invoice group, customer group, allergies, MRN, MEDA Days, Per Diem Days when applicable)
- Welcome Packets – prepare Welcome Packet to all new PVT patients / families
- Receptionist will mail and Print the packet
- Ensure documents in ECM Billing folders are worked timely
- Ensure Emails to Billing Email are worked timely
- Authorizations – gaining approval from facilities and families on non-covered meds or medication requiring authorization
- Manage Monthly Adjudication of Cycle Batches / Unit Dose Reject Batches
- Working assigned Customer Notes in a timely manner
- Adding Hospice and VA Med list
- Cubex Temp patients for LTC
- Work any BI-Call batches for homes
- Assist billing with rebilling / working open billing batches
- Communicate issues in preventing batches from being posted in a timely manner
- Assist with other projects as assigned
