Job Closed
This listing is no longer active.
CVS Health is a leading healthcare company operating CVS Specialty, CVS Pharmacy, CVS MinuteClinic, and CVS Caremark. In 2018, CVS combined forces with healthca
Adjudication Associate – Overnight
Location
Maine
Posted
4 days ago
Salary
$17 - $42 / hour
Seniority
Mid Level
Job Description
Adjudication Associate – Overnight
CVS Health
• responsible for the preparation and submission of claims for accounts to ensure timely reimbursements. • communicate with the nursing facility staff, physician offices, and insurance companies to maintain payment deliverables for online claim submissions. • follow established procedures to execute routine business support tasks for the Adjudication Omnicare function under general supervision. • develop effective relationships with all team members to ensure daily communication to resolve issues and prevent delays in service. • conduct review and research of rejected claims and take action for resolution. • handle work backlog of denied claims for timely resubmission. • ensure compliance with all government and regulatory requirements. • take direction to execute techniques, processes, and responsibilities.
Job 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).
Benefits
- medical, dental, and vision coverage
- paid time off
- retirement savings options
- wellness programs
- other resources, based on eligibility
Related Guides
Related Categories
Related Job Pages
More Associate Jobs
• Develop new litigation ideas and support the day-to-day in ongoing litigation • Help to develop legal strategies that advance clients’ policy objectives • Draft legal content such as regulatory comments, legal fact sheets, legal memorandum, and issue briefs • Closely follow legal and policy developments, political news, and industry trends • Coordinate with clients as needed and help cultivate relationships with external partners
Provider Success Associate
Tava HealthA mental health benefit for every employee. Because healthy minds matter.
• Conduct proactive, high-quality outreach to a book of providers • Maintain a consistent cadence of contact • Log every touchpoint, note, and outcome in HubSpot • Run monthly availability reviews with providers • Identify providers whose availability is trending down • Support providers as they grow • Lead feature-enablement sessions • Answer or route provider questions • Educate providers on Tava resources • Report bugs and service requests • Actively participate in team meetings • Contribute to and help refine the team's playbooks
• Responsible for negotiation with sites, finalization, and execution of all types of site contracts required for site activation including budget negotiations • Manage the negotiation, finalization, and execution of any amendments to the original contracts post site activation • Ensure the highest standard of quality of final documents and compliance with relevant regulatory requirements including ICH – GCP • Ensure that contracts meet needs of both clients and clinical trial sites, protecting best interests of clients and the company while nurturing positive relationships with clinical trial sites
• responsible for executing assigned conference projects, managing communications, and supporting events technology-related tasks • supports the live and virtual NTI (National Teaching Institute) content and logistics, including project oversight, documentation, and customer service • contributes to the Conference Business outcomes of the Events Team initiatives in keeping with organizational mission, vision, values, and strategic direction • Ensures the effective implementation and evaluation of key processes that support department and organizational goals and objectives • Coordinates specific inter- and intra-department processes • Responds to questions and addresses issues related to these processes • Creates new business processes aligned with department and organizational objectives • Assists on projects with defined outcomes and within agreed-upon parameters • Collaborates on cross-department and organization-wide projects • Evaluates department processes and systems, identifies opportunities for improvements, assembles key stakeholders, defines solutions, and implements action plans to improve efficiency, effectiveness, and customer satisfaction • Maintains effective communications with internal and external customers and key stakeholders • Ensures timely and effective response to requests for information from internal and external customers via telephone, e-mail, and mail • Collaborates with other team members to create and post content for department web pages and maintain branding and integrity of informational links • Coordinates with vendors and/or external customers to ensure compliance with contracts and processes • Develops and maintains data management systems • Establishes and maintains comprehensive files and databases to include historical data and current activities • Using computer-aided systems and applications generates regular reports related to programs and products • Provides effective general administrative support to the department • Coordinates administrative functions for team members, volunteers, and other key stakeholders, including forms processing, document management, travel arrangements, and expense reports • Monitors budget activity, developing routine and customized reports of financial activities • Reviews and processes vendor invoices • Proactively identifies and adjusts to variances • Supports department purchasing and preparation of annual and project budgets • Participates in orientation and cross-training of team members to ensure consistent support to internal and external customers • Additional duties as assigned




