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Pharmacy Billing Adjudicator - Evening Shift

Remote, USA Full-time Posted 2025-05-22

The MAC Rx Billing department is seeking a LTC Pharmacy Adjudicator to join the team! The ideal candidate will be thrive in a fast-paced environment, be able to multi-task and holds experience in a long term care pharmacy with multiple aspects of adjudication.
• *We are currently recruiting for the Evening shift
• *Hours: 6pm - 2:30am and/or 4:30pm - 1am**

Job duties include:

  • Process all admissions including demographics and insurance
  • Assist with all customer billing inquires in a courteous and professional manner
  • Understand and work with residents on account balances and patient records
  • Follow all applicable government regulations including HIPPA
  • Work with clients to ensure timely delivery of patient medications
  • Work live claim adjudication

Job requirements include:

  • Knowledgeable in Medicare Part D, public aid and third-party insurances
  • Knowledge of Prior Authorizations
  • Ability to adjudicate claims efficiently
  • Knowledge of adjudication process for LTC pharmacy is required
  • Knowledge of federal and state pharmacy laws and guidelines
  • Strong attention to detail
  • Self-motivated and able to work independently
  • 1 to 3 years of LTC pharmacy experience required
  • Pharmacy Technician License required
  • Ability to work weekends/holidays

This is a full time position with a competitive salary and full suite of benefits. Benefits include access to health, dental, vision, long-term disability, short-term disability and life insurance, company-matching 401(k) plan and paid time off.

Please apply today!

Job Type: Full-time

Benefits:
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:
• 8 hour shift

Experience:
• LTC pharmacy: 1 year (Preferred)
• Framework LTC software: 1 year (Preferred)

License/Certification:
• Pharmacy Technician Certification (Required)
• Illinois Pharmacy Technician License (Preferred)

Work Location: Remote

Apply Job!

 

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