Pharmacy Technician Licensed Specialist

Job Summary

Managing real-time insurance claims, the full-time remote Pharmacy Adjudication Specialist will analyze and approve claims, determine coverage, and resolve discrepancies while providing customer service to clients across multiple states.

Key responsibilities

• Work collaboratively with the CIC Department, Prior Authorization, and Billing Departments
• Submit claims, make necessary corrections, and ensure timely processing of real-time claims
• Communicate with facilities and third-party payers to resolve claim issues and discrepancies

Required qualifications

• Pharmacy Technician License in Ohio, West Virginia, Indiana, and Maryland (all preferred, but not required)
• Previous Long-Term Care pharmacy experience is a plus
• Knowledge of Framework LTC is a plus