May 30, 2020

Technician CIC Initiation LTC FT - 1270367BR

  • Professional Diversity Network
  • Des Plaines, IL, USA
Retail

Job Description

CVS Health

Job DescriptionOmnicare, Inc. is a wholly owned subsidiary of CVS Health Corporation. www.cvshealth.comWhat We DoDirectly, and through our subsidiaries, Omnicare provides a broad array of pharmacy-related services to long term care facilities and to other customers in the health care environment. While senior care has long been an Omnicare specialty, we also serve other targeted populations.The CIC, Claims associate is responsible for the timely and accurate distribution of phone calls and documents, as well as document storage throughout the CIC. Claims associates will research prior authorization (PA) requirements, gather all PA information needed, and complete the PA procedure in a timely manner. Are required to work with CIC staff, pharmacy staff, nursing facility staff and physician offices to ensure timely payment of online submission of claims and responsible for follow-up on all prior authorizations that have been submitted to the insurer for review. Shift: 10a - 6:30P, Monday - Friday; includes every 5th weekend, 12P - 8:30P. Plus 1 Major holiday per year.* Triage all incoming phone calls and faxes. * Scan, file and electronically store all prior authorizations and other CIC related documentation.* Work rejected real-time claims for all pharmacies supported by the CIC under the direction of the CIC pharmacists. o Work with local pharmacies to meet run times and ensure timely dispensing of medications. o Work with facility staff to gather pertinent information needed to secure overrides/prior authorizations.* Initiate Prior Authorizations as directed by a CIC pharmacist or Clinical Specialist.* Fax and electronically submit completed prior authorizations to insurance plans for review.* Call insurance plans to follow-up on submitted prior authorizations.* Communicate to the Supervisor staff and then escalate to the Claims Manager any changes in prior authorization criteria or issues related with various insurance plans and processors.* Work backlog of rejects as appropriate.* Follow all applicable government regulations including HIPAA. * Display behavior which exemplifies employee code of conduct guidelines.Required Qualifications*Must be proficient in data entry and Microsoft Office programs.*Strong verbal and written communication skills and the ability to work effectively cross-functionally with all levels.Preferred Qualifications*Minimum of 6 months to one year full-time Pharmacy experience.*Certified Pharmacy TechnicianEducation*High School degree or equivalent.Business OverviewIt's a new day in health care.Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation's premier health innovation company. Through our health services, insurance plans and community pharmacists, we're pioneering a bold new approach to total health. As a CVS Health colleague, you'll be at the center of it all.At CVS Health, we work every day to help people on their path to better health. Never has it been more important for us to deliver on our purpose to our valued customers, patients, members, and employees. With a presence in communities across the country, CVS Health colleagues are and will continue to be a critical piece of the country's health care solution. The health and safety of our employees, patients, customers, and members is our top priority as we face the impact of COVID-19 together. If you would like to learn about the actions we are taking as a company as we learn more about COVID-19 and its spread, we encourage you to visit our COVID-19 resource center at https://cvshealth.com/covid-19We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran - we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. Please note that we only accept applications for employment via this site.We provide reasonable accommodations to qualified individuals with disabilities. If you need to request an accommodation, a qualified interpreter, written information in other formats, translation or other services, please contact our Advice and Counsel Reasonable Accommodations team by emailing Advice and Counsel Reasonable Accommodations team or calling 877-805-9511.If technical issues are preventing you from applying to a position, contact Kenexa Helpdesk at 1-855-338-5609 or cvshealthsupport@us.ibm.com. For technical issues with the Virtual Job Tryout, contact the Modern Hire Help Desk at 1-877-451-1695 or cvs_support@modernhire.com.PDN-1270367BR

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