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Claims Adjudication Specialist

Community Pharmacy Omaha, NE

Do you like to problem solve and can t stop until you figure it out?  Does working with insurance companies make your day? Want to find a company that values their employees? A company that REALLY values them! Looking to find a company you ll be proud to be a part of?  Ever had a position that involved patient billing or adjudicating accounts? If you answered yes, then we want to meet you! Our long-term care pharmacy is looking to add only exceptional people to our team.

What will a Claims Adjudication Specialist do every day?  

  • Process Medicare, Medicaid, Hospice and Insurance claims for payment

  •  Interpret claims rejections and insurance denials

  •  Contact Insurance and Hospice plans for clarification and overrides

  •  Train to be an expert in pharmacy benefits to problem solve and resolve insurance issues

  •  Communicate with internal staff regarding claims rejections and Refill too soon outcomes

  •  Assist with DME claims adjudication

Claims Adjudication Specialist minimum requirements will include:

  •  High School Diploma, or equivalent  

  •  1-year coding and insurance processing experience preferred

  •  1-year word processing and/or data entry experience required

  •  1-year customer service experience required

  •  Knowledge of Medicare, Medicaid, coding and insurance processing a plus but will train 

  •  Knowledge of DME claims processing a plus but will train

  •  Strong written and oral communication skills required

  •  Strong organizational and analytical skills required  

  •  Must be able to actively contribute to a positive team environment

  •  Must be a self-starter with the ability to handle multiple tasks, remain focused, and work independently

  •  Must be detail oriented, and able to thrive in a fast-paced environment

  • Only an individual who is reliable and have a solid work history will be seriously considered for the position.  A completed pre-employment drug screen and background check will be conducted.

    This hourly position requires a schedule of Monday thru Friday between the hours of 7am to 6:30pm, with rotating weekend shifts.  Flexibility is a must.    

    Our Company is Community Pharmacy

    We are pioneers in long-term care pharmacy and continue to revolutionize the industry through innovative technology and personal innovative service. We pride ourselves in hiring exceptional individuals who are proactive and forward-thinking team players. Successful employees in the company are committed to playing a key role in keeping Community Pharmacy at the top of our industry. We are passionate about long-term care and in actively build partnerships with our clients.  Maintaining our positive work place culture is also true business success.

    Community Pharmacy is an Equal Opportunity Employer  


Date Posted July 30, 2022
Date Closes August 29, 2022
Requisition 471293
Located In Omaha, NE
SOC Category 00-0000.00

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