Questions? 1-888-481-3375

Branch No: 85063-7218
11800 Weston Parkway
Cary, NC 27513

Available Positions

1 positions available.

Claims Adjudication Specialists

Cary NC

Base Pay: $17.00 per hour

Our Cary NC client is seeking an experienced Claims Adjudication Specialist. The ideal candidate will have a background in electronic pharmacy clai...

Our Cary NC client is seeking an experienced Claims Adjudication Specialist. The ideal candidate will have a background in electronic pharmacy claims processing. This is an amazing call center environment with the potential for growth.

  • Handle claims requiring additional research, navigate through appropriate system platforms to perform research and resolve issues.
  • Work with other operational departments to research and resolve claims issues within performance agreement guidelines.
  • Create correspondence to members, internal departments, and external agencies regarding outstanding claims issues.
  • Compose letters to members or pharmacies for those claims with insufficient information or eligibility or benefit issues.
  • Evaluate claim submission, ensure all required information is present and determine what action should be taken.

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Staff Bios

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