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Northeast Georgia Health System
Winder, Georgia
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Pharmacy Billing Adjudicator
Job DescriptionAs the Pharmacy Billing Adjudicator for our Long Term Care business, you will be responsible for preparing and submitting claims for accounts. You will work directly with nursing facility staff, physician offices, and insurance companies to ensure timely payment of online claim submissions. You will also be responsible for reviewing and researching rejected third party claims, and problem solving to take appropriate action to resolve them. Additional key responsibilities include:- Working a backlog of rejected claims for timely resubmission- Managing your assigned queues to keep current on all claims- Clearing the workflow grid daily in order to meet productivity criteria- Handling specific denials including new patient overrides-
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