• Identifies coverage and sets up new claims in the claims system along with assigning the appropriate adjuster, appraiser, and/or vendor. • Documents and notates claims as necessary, including for contacts with clients and appraisal companies. • Handles incoming correspondence to assist lenders, borrowers, and third-party administrators. • Uploads and saves imaging documents into the claim system. • Performs other daily activities, including maintaining daily tracker, distributing mail to appropriate parties, logging customer complaints, and completing special projects. • Handles incoming calls in a phone queue and uses excellent customer service skills to gather claim information. • Review claims statuses and notate the claims system with the status. • Proven research skills with ability to quickly locate and analyze relevant data. • High level of self-motivation and discipline to work independently. • Ability to prioritize tasks, manage time effectively, and meet deadlines. • Strong analytical and problem-solving skills. • Excellent communication and organizational skills. • Examines and researches inquiries from customers regarding the claims process, status, and settlements. • Reconciles weekly claim reserves to ensure proper tracking and reporting of reserves. • Releases custom weekly reports to carriers, clients, and third-party administrators. • Performs other duties as required.

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a 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. - 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. Required Qualifications - At least 1 year of experience in customer service. - Basic proficiency with desktop software applications, particularly Microsoft Excel and Microsoft Access. - Must be able to work overnight (9pm-5:30am EST), as well as be willing to work weekends and holidays on a rotating schedule. Preferred Qualifications - Pharmacy technician certification. - Experience in pharmacy, managed care, Medicaid and/or Medicare organizations. - Ability to perform multiple tasks effectively. - Ability to work both independently and as part of a team. Education - High School Diploma or GED. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $17.00 - $34.15 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. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: - Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. - No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. - Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 03/20/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Role Description Under the direction of the Director or Manager of Revenue Cycle Management, the Medical Claims Billing Specialist (Accounts Receivable (AR) Manager) is responsible for complete, accurate and timely processing of all designated claims, reviewing and responding to daily correspondence from physician practices in a timely manner, answering incoming SalesForce cases and providing information as requested or properly authorized. The AR Manager will take steps necessary to resolve all claim issues or questions that escalate to the RCM team. Resolution of SalesForce cases and management of issues and the team resolving the cases is a key element in this role. - Management of the accounts receivable (AR) including analysis of the aged AR, looking for root cause issues; writing rules where appropriate to stop errors from occurring. - Denial management - investigating denial sources, resolving and appealing denials which may include contacting payer representatives. - Makes independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques. - Collaborate internal teams (Performance, Operations, Sales) as well as care center staff when appropriate. - At times, support large care center go lives which may include overnight travel. - Works closely with our Revenue Optimization team, to support efforts to ensure reimbursement is in line with payer contract agreements. Performs Denial analysis utilizing the Trizetto platform. - Work directly with practice consultants or physicians to ensure optimal revenue cycle functionality. - Drive toward achievement of department’s daily and monthly Key Performance Indicators (KPIs), requiring a team focused approach to attainment of these goals. - Other duties as assigned. Qualifications - High School Graduate - 3+ years experience in a physician medical billing office - Athena EHR experience highly preferred - CareFirst MD experience highly preferred - Medicare Advantage & USDOL experience preferred - Experience with major payers such as Anthem, Medicare/Medicaid, United Healthcare, Carefirst also preferred. - Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims & denial trends. - Advanced Microsoft Excel & Google Sheets skills (e.g., pivot tables, VLOOKUP, sort/filtering, formulas) and proficiency in Google Sheets preferred - Must comply with HIPAA rules and regulations Requirements - The hourly range for this role is $24.45/hr to $26.45/hr in hourly base pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). - This role is also eligible for an annual bonus targeted at 10%. - The base pay offered will be determined based on relevant factors such as experience, education, and geographic location. Benefits - Expense reimbursement for remote workers to offset internet costs. Company Description Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.

• Deliver prompt and accurate claims service to policyholders and agents for both multi-peril crop insurance (MPCI) and crop hail claims • Complete field inspections, communicating with involved parties, performing investigations, determining appropriate adjustments • Partner with Field Claims Manager to ensure effective and efficient claims operations • Accurately document, process and transmit loss information • Provide overflow support to Compliance Department of quality control audits for Federal Crop Insurance Corporation (FCIC and Crop Hail) • Build and maintain relationships with customers by providing timely and accurate policy service • Coach claims adjusting team by supporting and mentoring team members