Adjudication Associate (Omnicare) - Overnight

CVS Health • Santa Fe, NM • 2h ago

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

The Adjudication Associate (Omnicare) is responsible for the preparation and submission of claims for accounts to ensure timely reimbursements. This person will communicate with the nursing facility staff, physician offices, and insurance companies to maintain payment deliverables for online claim submissions.

Responsibilities:

Follows established procedures to execute routine business support tasks for the Adjudication Omnicare function under general supervision.

Develops effective relationships with all team members to ensure daily communication to resolve issues and prevent delays in service.

Conducts review and research of rejected claims and takes action for resolution.

Handles work backlog of denied claims for timely resubmission.

Ensures compliance with all government and regulatory requirements.

Takes direction to execute techniques, processes, and responsibilities.

Required Qualifications

At least 1 year of experience in a pharmacy-based setting.

At least 1 year of experience in customer service.

Basic proficiency with desktop software applications, particularly Microsoft Excel and Microsoft Access.

Must be able to work Monday-Friday from 9:00pm-5:30am Eastern Standard Time, as well as be willing to work weekends (once every three weeks) and holidays (several times per year).

Preferred Qualifications

Pharmacy technician certification.

Previous experience in managed care and Medicaid and/or Medicare organizations.

Ability to perform multiple tasks effectively.

Ability to work both independently and as part of a team.

Ability to operate independently.

Dedicated and reliable nature.

Education

High school diploma or GED.

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$17.00 - $34.15

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan .

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 12/30/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

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