LTC Pharmacy Adjudicator - IL MA Licensed - Mission Viejo California

Company: VirtualVocations
Location: Mission Viejo, California
Posted On: 11/17/2024

A company is looking for a LTC Pharmacy Adjudicator responsible for managing medication order exceptions and coordinating claims adjudication.



Key Responsibilities

Communicate with communities regarding non-formulary and expensive medication orders, providing education on alternatives
Review and resolve Medicare D rejections and prior authorizations, coordinating with pharmacists and physicians
Maintain patient account information and submit claims to third parties, identifying and resolving claim denials


Required Qualifications

High School diploma or GED
Pharmacy Technician License and/or Certification (CPhT) as per state requirements
Minimum one year of data entry experience
General computer knowledge, including Microsoft Office: Word, Excel, and Outlook
Strong knowledge of Brand/Generic drugs and medical terminology More...

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