Adjudication Associate – Overnight

CVS Health

Adjudication Associate processing Omnicare pharmacy claims for CVS Health. Researching rejected claims, resolving denials, and submitting claims for timely reimbursement during overnight hours.

Posted 8/5/2026full-timeRemote • Louisiana, Minnesota, Mississippi, Montana, North Carolina • 🇺🇸 United StatesJuniorMid-Level💰 $17 - $34 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in claims preparation and submission, ensuring compliance with regulatory requirements while maintaining effective communication with healthcare professionals. Proficient in managing denied claims and executing business support tasks in a pharmacy-based environment.

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 SubmissionClaims ResolutionRegulatory ComplianceBusiness Support TasksData Research

Soft Skills

Effective CommunicationTeam CollaborationProblem SolvingReliabilityMultitasking

Tools & Technologies

Microsoft AccessDesktop Software Applications

Certifications & Qualifications

Pharmacy Technician Certification

Industry Keywords

Managed CareMedicaidMedicarePharmacy-Based Setting

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 backlogs 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
Ability to work Monday–Friday from 9:00 p.m.–5:30 a.m. 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 independently and as part of a team
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
Comprehensive benefits package for eligible full-time colleagues and their families