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Cabin Creek

    Pharmacy Adjudication Technician - Cabin Creek, United States - Pharmacy Solutions Group

    Pharmacy Solutions Group
    Pharmacy Solutions Group Cabin Creek, United States

    3 weeks ago

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    Description
    Pharmacy Solutions Group - West Virginia -

    Pharmacy Adjudication Technician

    Pharmacy Solutions Group is currently recruiting an Adjudication Technician to join our West Virginia team
    Responsibilities:

    * Responsible for adjudication of daily unit dose and non-unit dose claims

    • Contacting insurance for proper overrides

    * New Admits for assigned homes (MOP, group codes, tax group, addresses, invoice group, customer group, allergies, MRN, MEDA Days, Per Diem Days when applicable)

    • Contacting families on new admits ensuring we have the proper method of payment established when no insurance found or address issues.
    • Running New Admit Report on a weekly basis auditing admits for (MOP, group codes, tax Group, addresses, invoice group, customer group, allergies, MRN, MEDA Days, Per Diem Days when applicable)
    • Welcome Packets – prepare Welcome Packet to all new PVT patients/families
    • Receptionist will mail and Print the packet

    * Ensure documents in ECM Billing folders are worked timely

    * Ensure Emails to Billing Email are worked timely

    * Authorizations – gaining approval from facilities and families on non-covered meds or medication requiring authorization

    * Manage Monthly Adjudication of Cycle Batches/ Unit Dose Reject Batches

    * Working assigned Customer Notes in a timely manner

    * Adding Hospice and VA Med list

    * Cubex Temp patients for LTC

    * Work any BI-Call batches for homes

    * Assist billing with rebilling/working open billing batches

    • Communicate issues in preventing batches from being posted in a timely manner

    * Assist with other projects as assigned

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