Pharmacy Adjudication/Reimbursement Specialist - Immediate Opening

Absolute Health Services; North Canton (OH); On-site; USD 38,000 - 59,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Paid time off

Holidays

Shift differential after 5pm

Job summary

Absolute Health Services in North Canton, OH is seeking a Pharmacy Adjudication / Reimbursement Specialist to ensure accurate billing for prescriptions. You will verify patient demographics and insurance details, submit claims electronically, and handle prior authorizations while maintaining payer compliance.

The role offers a comprehensive benefit package including medical and dental insurance, paid time off, holidays, and a shift differential after 5pm.

Qualifications

• State registration required.
• Pharmacy Technician Certification required within 1 year of hire.
• Strong attention to detail and organizational skills.
• Excellent written and verbal communication skills.
• Ability to multitask and manage competing priorities.
• Self-motivated with the ability to work both independently and as part of a team.
• Basic proficiency in Microsoft Word and Excel.

Responsibilities

• Verify patient demographics and insurance information for accuracy.
• Submission of claims to Insurance Companies electronically.
• Perform insurance verifications and eligibility checks.
• Handle inbound and outbound calls with facilities, guarantors, and insurance companies.
• Initiate and follow up on prior authorizations.
• Review and respond to insurance audit requests.
• Investigate and resolve insurance and Medicaid rejections.
• Maintain accurate documentation of all billing activities.
• Perform other duties as assigned.

Skills

Attention to detail

Communication skills

Multitasking

Teamwork

MS Word & Excel

Education

State registration required

Pharmacy Technician Certification within 1 year of hire

Tools

Microsoft Word

Excel

Job description

An opportunity with your name on it. Become a CNA.

Careers with absolute

Grow With Us

Across our multiple divisions, we touch people’s lives in their homes and in long-term care facilities. We address health needs related to physical therapy, medications, in-home nursing services, independent living assistance like meal preparation and companionship, and end-of-life care. Find out more, here .

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Position:Pharmacy Adjudication/Reimbursement Specialist - Immediate Opening

Location: North Canton, OH

Job Id:13467

# of Openings:1

Pharmacy Adjudication / Reimbursement In Office Specialist

Position Summary

We are seeking a detail-oriented and motivated Pharmacy Adjudication / Reimbursement Specialist to join our Long Term Care Pharmacy team in North Canton Office. This role is essential in ensuring accurate billing and reimbursement for prescriptions by verifying patient and insurance information, resolving claim issues, and maintaining compliance with payer regulations and guidelines. The ideal candidate thrives in a fast-paced environment and is committed to delivering high-quality service.

Benefit Package includes comprehensive medical, dental insurance along with earned Paid Time off and Holidays. Shift differential after 5pm additional wage added.

Schedule

• Full-Time Position
• shift's available: 1:00pm 9:30pm non remote
• Sundays Half shift 7pm-11pm remote
• Saturdays 1 every 3 -4 weeks 9am-5:30pm remote

Qualifications

• State registration required
• Pharmacy Technician Certification required within 1 year of hire
• Strong attention to detail and organizational skills
• Excellent written and verbal communication skills
• Ability to multitask and manage competing priorities
• Self-motivated with the ability to work both independently and as part of a team
• Basic proficiency in Microsoft Word and Excel

Key Responsibilities

• Verify patient demographics and insurance information for accuracy
• Submission of claims to Insurance Companies electronically
• Perform insurance verifications and eligibility checks
• Handle inbound and outbound calls with facilities, guarantors, and insurance companies
• Initiate and follow up on prior authorizations
• Review and respond to insurance audit requests
• Investigate and resolve insurance and Medicaid rejections
• Maintain accurate documentation of all billing activities
• Perform other duties as assigned

As a Reimbursement Specialist, you will play a vital role in supporting our mission by ensuring accurate, timely billing and exceptional customer service. You will collaborate closely with team members to promote quality outcomes, operational efficiency, and overall employee satisfaction.

Why Join Us?

• Supportive team environment
• Opportunity for growth and certification
• Meaningful work that impacts patient care behind the scenes

We are constantly working to raise the bar in our recruitment, application process, and nurse aide training courses. If you have any questions or concerns, please let us know.

7171 Keck Park Circle NW | North Canton, OH 44720