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Adjudication Specialist

BrightSpring Health Services
USD $18.00/Hr. - USD $26.00/Hr.
paid time off, tuition reimbursement, 401(k), retirement plan
United States, Colorado, Englewood
Jan 13, 2025

Adjudication Specialist
Job Locations

US-CO-ENGLEWOOD


ID
2024-157719

Line of Business
Amerita

Position Type
Full-Time

Pay Min
USD $18.00/Hr.

Pay Max
USD $26.00/Hr.



Our Company

Amerita



Overview

Come join our closed-door specialty infusion pharmacy! Amerita is a leading provider of Specialty Infusion services focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. As one of the most respected Specialty Infusion providers in America, we service thousands of patients nationwide through our growing network of branches and healthcare professionals.

The Adjudication Specialist will be responsible for all aspects of pharmacy and medical claims adjudication, accuracy of pharmacy and medical claims, resolution of third-party rejections, and coordination of benefits.

SCHEDULE:

Monday - Friday in Centennial

10:00am - 6:30pm / Saturday rotation

* Medical, Dental & Vision Benefits plus, HSA & FSA Savings Accounts
* Supplemental Coverage - Accident, Critical Illness and Hospital Indemnity Insurance
* 401(k) Retirement Plan with Employer Match
* Company paid Life and AD&D Insurance, Short-Term and Long-Term Disability
* Employee Discounts
* Tuition Reimbursement
* Paid Time Off & Holidays



Responsibilities

    Processes pharmacy and medical claims accurately and efficiently, ensuring compliance with payer policies and guidelines.
  • Verifies accuracy of claim submissions, including medication codes, quantities and pricing and resolve any discrepancies or errors.
  • Knowledgeable to perform all Document Management functions. Provides thorough, accurate and timely responses to requests.


Qualifications

  • High School Diploma or GED or licensed/registered pharmacy technician or previous experience in Pharmacy
  • 1+ years pharmacy experience
  • Pharmacy or healthcare-related knowledge
  • Knowledge of pharmacy terminology including sig codes, and Roman numbers, brand/generic names of medication
  • Basic math and analytical skills
  • Intermediate typing/keyboard skills


About our Line of Business

Amerita is a specialty infusion company focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. Committed to excellent service, our vision is to combine the administrative efficiencies of a large organization with the flexibility, responsiveness and entrepreneurial spirit of a local provider. For more information about Amerita, please visit www.ameritaiv.com. Follow us on TwitterandLinkedIn.


Additional Job Information

Shift Differential after 5:30pm on Weekdays and on Saturdays.



Salary Range

USD $18.00 - $26.00 / Hour
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