Find & Apply For Claims Specialist / Adjuster / Examiner Jobs in Glen Burnie, Maryland

Pharmacy Claims Specialist

Job Address:

799 Cromwell Park DrSuites K-MGlen Burnie, MD 21061

Pharmacy Claims SpecialistResponsibilities:

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

• Contacting insurance for proper overridesNew 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 packetEnsure documents in ECM Billing folders are worked timelyEnsure Emails to Billing Email are worked timelyAuthorizations - gaining approval from facilities and families on non-covered meds or medication requiring authorizationManage Monthly Adjudication of Cycle Batches/ Unit Dose Reject BatchesWorking assigned Customer Notes in a timely mannerAdding Hospice and VA Med listCubex Temp patients for LTCWork any BI-Call batches for homesAssist billing with rebilling/working open billing batches•Communicate issues in preventing batches from being posted in a timely mannerAssist with other projects as assigned