Jobs · OTHR

Adjudication Associate (Omnicare) - Overnight

CVS Health · Augusta, ME · 4 days ago
RemoteRemoteOTHR$17–$42.35/hrFull-time

Position Summary

The Adjudication Associate (Omnicare) is responsible for the preparation and submission of claims for accounts to ensure timely reimbursements. This person will communicate with the nursing facility staff, physician offices, and insurance companies to maintain payment deliverables for online claim submissions.

Responsibilities

  • Follows established procedures to execute routine business support tasks for the Adjudication Omnicare function under general supervision.
  • Develops effective relationships with all team members to ensure daily communication to resolve issues and prevent delays in service.
  • Counsels and resolves issues related to claims processing.
  • Conducts review and research of rejected claims and takes action for resolution.
  • Handles work backlog of denied claims for timely resubmission.
  • Ensures compliance with all government and regulatory requirements.
  • Takes direction to execute techniques, processes, and responsibilities.

Requirements

  • At least 1 year of experience in a pharmacy-based environment.
  • Basic proficiency with desktop software applications, particularly Microsoft Excel and Microsoft Access.
  • Must be able to work Monday-Friday from 9:00pm-5:30am Eastern Standard Time, as well as be willing to work weekends (once every three weeks) and holidays (several times per year).

Preferred Qualifications

  • Pharmacy technician certification.
  • Previous experience in managed care and Medicaid and/or Medicare organizations.
  • Ability to perform multiple tasks effectively.
  • Ability to work both independently and as part of a team.
  • Ability to operate independently.
  • Dedicated and reliable nature.

Education

  • A high school diploma or GED.

Pay Range

The Typical Pay Range For This Role Is $17.00 - $42.35 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

Benefits

We anticipate the application window for this opening will close on: 07/18/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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