Description:

　　Day to day includes census (skilled nursing facilities and making sure reports are updated) and admissions, adjudication of all claims from pharmacy, customer service, working with prior authorizations, also has skilled business so billing on that as well (Medicaid and managed care)

　　Hybrid billing department

　　Adjudication of claims for pharmacy census; PA, insurance authorizations

　　Skilled business; billing and doing census for Medicaid part A and then managed care

　　Mixture of inbound and outbound of calls

　　Family members, nurses, Med tech

　　Experience:

　　Come from the pharmacy, they need the knowledge of the medication to understand the backside of the business. Retail candidate have been more successful. Would like a min of 2 years of experience, would take anyone if it's a year.

　　Skills:

　　claims adjudication, Pharmacy, Data entry, Customer service, Prior authorization, Retail pharmacy, Call center, Insurance, Pharmacy technician certification, Cpht

　　Additional Skills & Qualifications:

　　Would prefer to have FrameWork exp, but not necessary

　　Diversity, Equity & Inclusion

　　At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

　　Hiring diverse talent

　　Maintaining an inclusive environment through persistent self-reflection

　　Building a culture of care, engagement, and recognition with clear outcomes

　　Ensuring growth opportunities for our people

　　Actalent is an equal opportunity employer.

　　About Actalent

　　Actalent connects passion with purpose. We help visionary companies advance their engineering and science initiatives through access to specialized experts that drive scale, innovation, and speed to market. With a network of almost 30,000 engineering and sciences consultants and more than 4,500 clients across the U.S., Canada, Asia, and Europe, Actalent serves many of the Fortune 500. An operating company of Allegis Group, the global leader in talent solutions, Actalent launched as a new specialized engineering and sciences services and workforce solutions brand in 2021.