Adjudication Associate – Overnight

CVS Health

. Prepare and submit claims for accounts to ensure timely reimbursements .

Posted 10/2/2026full-timeRemote • United StatesJuniorMid-Level💰 $17 - $34 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in claims preparation and submission, ensuring compliance with government regulations and effective communication with healthcare professionals. Proficient in managing denied claims and maintaining relationships to facilitate timely reimbursements.

Highest-signal resume keywords

Claims PreparationCustomer ServiceMicrosoft ExcelPharmacy Technician CertificationManaged Care Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims SubmissionReimbursement ProcessingIssue ResolutionRegulatory ComplianceData Research

Soft Skills

Team CollaborationEffective CommunicationReliabilityIndependenceMultitasking

Tools & Technologies

Microsoft AccessDesktop Software Applications

Certifications & Qualifications

Pharmacy Technician Certification

Industry Keywords

Pharmacy-Based SettingManaged CareMedicaidMedicare

About the role

Key responsibilities & impact

Prepare and submit claims for accounts to ensure timely reimbursements
Communicate with nursing facility staff, physician offices, and insurance companies to maintain payment deliverables for online claim submissions
Execute routine business support tasks for the Adjudication Omnicare function under general supervision
Develop effective relationships with team members to ensure daily communication, resolve issues, and prevent service delays
Review and research rejected claims and take action for resolution
Handle backlog of denied claims for timely resubmission
Ensure compliance with government and regulatory requirements
Follow direction to execute techniques, processes, and responsibilities

Requirements

What you’ll need

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
Willingness to work weekends once every three weeks
Willingness to work holidays several times per year
High school diploma or GED
Pharmacy technician certification preferred
Previous experience in managed care and Medicaid and/or Medicare organizations preferred
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

Benefits

Comp & perks

Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being
Full-time position with comprehensive benefits package