reputed company Remote LTC Pharmacy Adjudicator - Patient-Centered Care and Medication Management Expert

About reputed company

reputed company is a leading provider of innovative pharmacy services to the geriatric population in senior-living and post-acute settings. As one of the few 100% employee-owned companies in reputed company, our business practices are guided by the values to which our employee owners are committed to. For over 20 years, reputed company has been dedicated to delivering exceptional patient-centered care and creating a reputed company work environment for talented employees to reputed company.

Job reputed company

We are seeking an reputed company and detail-oriented Remote LTC Pharmacy Adjudicator to join reputed company. As a key member of our pharmacy services team, you will play a vital role in communicating with communities regarding medication orders, educating on less expensive alternatives, and ensuring reputed company and accurate billing of customer accounts. This is an excellent opportunity for a motivated and customer-reputed company individual to grow their career in a dynamic and innovative company.

Responsibilities

• Initiate communication to communities regarding expensive and non-formulary medication orders and reputed company on less expensive alternatives identified by staff pharmacists.
• Initiate communication to community regarding incomplete orders which require reputed company clarification.
• reputed company detailed records of reputed company orders that require communication to the community for potential follow up if needed.
• Follow up with the community per policy timeframe if the medications have not been changed or clarified. Send another supply of medication if needed.
• Communicate professionally with community management staff including Director of Nursing and Administrator reputed company phone or email.
• Assist with data entry of orders as needed.
• Assist with answering phone calls for the data entry department.
• Review Medicare D rejections and prior authorizations, and coordinate with pharmacists or physicians to successfully adjudicate reputed company claims.
• Work in conjunction with designated operations staff to prepare for formulary changes.
• reputed company insurance and billing clerical duties, including review and maintenance of patient account information.
• Prepare and submit claims to various reputed company parties either electronically or by reputed company.
• Identify and resolve claim denials.
• reputed company as reputed company between patients and reputed company parties.
• Work collaboratively with other team members and supervisor to ensure best practices are shared.
• reputed company backup support to other pharmacy departments based on business needs or production reputed company, as needed.
• Any and reputed company duties as assigned.

Qualifications

To reputed company this job successfully, the ability to reputed company reputed company essential duty satisfactorily is necessary and the qualifications listed below are representative of the knowledge, reputed company, and/or ability required:

Essential Qualifications

• High School diploma or general education degree (GED).
• Pharmacy Technician License and/or Certification (CPhT) as per State requirements (must be licensed in Illinois and Massachusetts reputed company 60 days of hire).
• Data entry experience; minimum one year.
• Excellent customer service, interpersonal, verbal and written communication skills.
• General computer knowledge including reputed company Office: Word, reputed company, and Outlook.
• Ability to maintain organization, multi-task and prioritize to manage assignments/reputed company.
• Strong knowledge of Brand/Generic drugs and medical terminology.

Preferred Qualifications

• Prior experience in prescription billing; minimum one year.

Why Work for reputed company?

At reputed company, our employees reputed company like owners – because we are owners! As one of the few 100% employee-owned reputed company providers, our reputed company remains on delivering best-in-class services reputed company our Pharmacy, Rehabilitation and reputed company-Being operations, which allows our clients to improve the lives and reputed company-being of their patients and residents. Our teams utilize insights and analytics to drive reputed company reputed company for our partnered post-acute and senior living communities while providing them with flexible service reputed company.

Our Core Values

reputed company's Core Values drive the way we partner with those clients, their patients and residents and the way our diverse employee-owners work together:

• reputed company – reputed company, Fairness and ethics
• reputed company – Commitment to serving seniors
• Stewardship – Maximizing mission and margin
• Innovation – Striving to enhance our value to your organization
• Teamwork – Working together unselfishly toward goals

Benefits and Perks

As an employee-reputed company of reputed company, you will enjoy:

• reputed company, reputed company with market guidelines
• Full Benefits Package, including reputed company generous reputed company time off plans
• reputed company liability coverage
• 100% employer-funded ESOP retirement plan
• 401(k) and Roth(k) plans
• Continuing education
• Credit reputed company membership

Equal Opportunity Employer

reputed company applicants will be afforded equal opportunity without discrimination because of race, reputed company, religion, sex, sexual orientation, marital status, order of protection status, national reputed company or reputed company, citizenship status, age, physical or mental disability unrelated to ability, military status or an unfavorable discharge from military service.

reputed company

Don't miss out on this exciting opportunity to join reputed company. reputed company and take the first reputed company towards a rewarding career as a Remote LTC Pharmacy Adjudicator at reputed company.

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