CVS Health RB Billing Adjudicator I in Sanford, Florida

More information about this job


A Billing Adjudicator is responsible for preparing and submitting claims for accounts and works with nursing facility staff, physician offices, and insurance companies to ensure timely payment of online submission of claims.


  • Review and research rejected Third-Party claims taking appropriate action to resolve.

  • Work backlog of denied claims for timely resubmission.

  • Manage assigned queues keeping up-to-date and current on all claims.

  • Workflow grid is cleared daily meet productivity criteria

  • Specific denials including new patient overrides

  • Follow all applicable government regulations including HIPAA.

  • Display behavior which exemplifies the Core Values.

  • Other duties as deemed necessary


Minimum (Required): (must be met in order to perform the job at the required level)

  • High school diploma

  • Entry-Level familiarity with Excel/Access

  • Perform multiple tasks effectively

  • Able to work both independently and as part of a team

Preferred: (if above and beyond the minimum required)

  • Pharmacy technician certification highly preferred

  • Experience in pharmacy, managed care, Medicaid and/or Medicare organizations

Hours: 1130am-8pm Wednesday and Sunday off

Physical Demands: May sit, stand, stoop, bend and walk intermittently during the day. May sit or stand seven (7) to ten (10) hours per day. May be necessary to work extended hours as needed. Finger dexterity to operate office equipment required. May need to lift up to twenty-five (25) pounds on occasion. Visual acuity to see and read fine prints. Specific vision abilities required by this role include close vision, color vision and the ability to adjust focus. Must be able to hear normal voice sounds. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this role. Business travel as necessary.

Work Environment: Work in a climate-controlled, smoke-free internal environment.

Equal Opportunity Employer: Omnicare is fully committed to employing a diverse workforce. We recruit and retain talented individuals without regard to gender, race, age, marital status, disability, veteran status, sexual orientation and gender identity or any other status protected by federal, state or local law. Omnicare is an Equal Employment Opportunity and Affirmative Action Employer.


Business Overview

Omnicare, Inc. is a wholly owned subsidiary of CVS Health Corporation.

What We Do

Directly, and through our subsidiaries, Omnicare provides a broad array of pharmacy-related services to long term care facilities and to other customers in the health care environment. While senior care has long been an Omnicare specialty, we also serve other targeted populations.

Commitment at Every Level

A large part of Omnicare's success derives from a commitment, at every level, to the welfare of each individual we serve. Each day, our employees consider how their work can improve the quality of life of residents and patients. Omnicare is truly a health care company, working to improve the health and quality of life for everyone we touch.

Requisition ID 2016-22051

Position Type Regular Full-Time

Job Locations US - FL - Sanford

Division LTC

Category Billing