What are the responsibilities and job description for the Adjudication/Reimbursement Specialist position at Absolute Companies?
- State registration required
- Pharmacy technician certification must be obtained within 1 year of hire
- Flexible scheduling – 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