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Adjudication Jobs in Ohio (NOW HIRING)

Apex Informatics

Data Analyst

Mason, OH · On-site

Experience understanding claim adjudication for member and provider reimbursements. * Experience with Facets platform using Claims, Provider, Network, Product Benefit Configuration * Knowledge of ...

City of Cleveland

Commercial Plan Examiner

Cleveland, OH · On-site

$82K - $87K/yr

Prepares correction letters, adjudication orders, and plan approval letters. Provides code consultation with applicants, design professionals, contractors, and developers. Represents the Department ...

Amentum

Telecommunications Specialist

Dayton, OH · On-site

This position requires an active DoD TS/SCI security clearance that has been adjudicated in the last 5 years or designated CE and the ability to obtain and maintain special accesses. Work Schedule:

Managed Staffing

Claims Processor

Mason, OH · On-site

$16 - $20.25/hr

Through demonstrated experience and knowledge, process standard, non-complex claims requiring a basic knowledge of claims adjudication. MAJOR DUTIES & RESPONSIBILITIES: * Processing - Efficiently and ...

Riverside Research

Cloud Architect

Fairborn, OH

$61.50 - $78.25/hr

Ability to obtain a Top Secret clearance with SCI adjudication. * Bachelor's degree and 10+ years of experience in cloud architecture or related roles. * Proven experience designing and managing ...

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Adjudication information

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$14

$35

$44

How much do adjudication jobs pay per hour?

As of Aug 27, 2026, the average hourly pay for adjudication in Ohio is $35.16, according to ZipRecruiter salary data. Most workers in this role earn between $29.95 and $40.67 per hour, depending on experience, location, and employer.

What is adjudication?

An adjudication job involves reviewing and analyzing claims, applications, or cases to determine eligibility, compliance, or resolution based on established guidelines and policies. Adjudicators work in various fields such as insurance, legal disputes, government benefits, and background checks. Their role includes reviewing documents, verifying information, and making impartial decisions to ensure fair outcomes. Strong attention to detail, analytical skills, and knowledge of relevant regulations are essential for this role.

What are the common responsibilities of adjudication?

Professionals working in Adjudication are responsible for reviewing claims, appeals, or disputes to determine their eligibility or validity based on established guidelines and regulations. Daily tasks often include gathering and analyzing evidence, preparing detailed reports, and communicating decisions to involved parties while ensuring compliance with all applicable laws and policies. Adjudicators also collaborate frequently with internal teams such as customer service, legal, and compliance departments to ensure thorough and accurate decision-making. This role often involves managing multiple cases simultaneously, making strong organizational and time-management skills essential for success.

What are the key skills and qualifications needed for adjudication?

To excel in an Adjudication role, candidates typically need strong analytical abilities, attention to detail, and a background in legal, insurance, or compliance fields, often supported by a relevant degree or professional certification. Familiarity with case management systems, claims processing software, and regulatory databases is commonly required. Excellent problem-solving, communication, and impartial decision-making skills help professionals stand out in this position. These attributes are critical for ensuring fair, consistent, and efficient resolutions in complex claims or disputes.

How much does a claim adjudicator make?

A claim adjudicator typically earns between $40,000 and $70,000 annually, depending on experience, location, and the employer. The role often requires strong attention to detail and knowledge of insurance policies or healthcare regulations.

What are the most commonly searched types of Adjudication jobs in Ohio?

The most popular types of Adjudication jobs in Ohio are:

What are popular job titles related to Adjudication jobs in Ohio?

For Adjudication jobs in Ohio, the most frequently searched job titles are:

What job categories do people searching Adjudication jobs in Ohio look for?

The top searched job categories for Adjudication jobs in Ohio are:

What cities in Ohio are hiring for Adjudication jobs?

Cities in Ohio with the most Adjudication job openings:

Adjudication jobs near you
Infographic showing various Adjudication job openings in Ohio as of August 2026, with employment types broken down into 79% Full Time, 17% Part Time, and 4% Contract. Highlights an 70% Physical, 5% Hybrid, and 25% Remote job distribution, with an average salary of $73,142 per year, or $35.2 per hour.

Adjudication Pharmacy Technician

North Canton, OH • On-site

Innovative Rx Us Holdings, Inc.
See more jobs at Innovative Rx Us Holdings, Inc.external

$15.50 - $19/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 24 days ago

Job description

Adjudication Pharmacy Technician

Finney's Institutional Pharmacy is seeking a motivated and customer-oriented individual to join our team as an Adjudication Pharmacy Technician. As a vital part of our adjudication team, you will be responsible for ensuring prescriptions are dispensed to eligible patients and billed properly in accordance with their benefit plan. Additionally, you will maintain a positive and pleasant demeanor with all customers and colleagues while accurately confirming eligibility and billing.

Responsibilities:
  • Perform billing duties as needed
  • Understand the pharmacy front-end process and perform point of sale functions (adjudication)
  • Contact payors and/or other outside agencies to verify information and resolve common, non-clinical problems
  • Run weekly billing reports
  • Obtain accurate billing and resident information, and rebill and resolve unpaid claims through adjudication
  • Re-bill and reconcile all incorrectly billed, non-clinical third-party denials
  • Identify and resolve and process denied claims in a timely manner
  • Document all communication concerning denied claims and any resolution communicated to facility or physicians
  • Obtain Prior Authorizations and non-covered forms
  • Obtain Part B documentation
  • Assist with billing DME supplies on line (Medicaid)
  • Resolve Hospice denials and communicate to Hospice nurses any denied claims
  • Adhere to and demonstrate mastery of current operating procedures
  • Use DocuTrack skills to locate specific documents and fax documents to facilities and/or for audit purposes
  • Stay in line with End of Month processes and deadlines
  • Ensure customer requests are handled quickly and professionally
  • Communicate effectively with customers to resolve billing inquiries
  • Communicate effectively with third party payors to resolve denied claims
  • Complete and verify pricing requests for customers
  • Direct specific inquiries to the appropriate team / individual
  • Maintain a positive, pleasant demeanor with all customers
  • Utilize robust problem-solving and people skills, patience, and telephone etiquette
  • Document customer issues using CPAS form and communicate to management
  • Work with Billing/Collection Managers on special projects as needed
  • Other duties as assigned
Qualifications:
  • Active pharmacy technician license from the Ohio State Board of Pharmacy preferred
  • Previous pharmacy experience extremely valuable and desired
  • At least 1 year of billing experience
  • Proficient in Microsoft word and Excel
Working Conditions:
  • Normal working hours: Monday through Friday, 8:30AM to 5:30PM, with additional time as required based on daily workloads.
  • This position may also include sitting for long periods of time.
  • Participation in the on-call rotation is voluntary, with incentive pay provided.
  • Adjudication team members must work well together as a team.
  • This position involves multiple hours of phone time per day speaking with Finney's doctors, leaders, administrators, and patients.
Physical Requirements:
  • This position requires sitting for extended periods of time.
  • Operating a desktop keyboard and mouse.
  • Communicating with employees, patients, caregivers, and physicians by phone, fax, and email in a courteous and professional manner.
We Proudly Offer:
  • (Primarily) Monday - Friday Day Shift
  • Closed for 6 Paid Holidays
  • 14 Days of PTO in the first year
  • Multiple Healthcare Plans
  • Dental and Vision Coverage
  • Free Life Insurance
  • Supplemental Insurance Plans
  • 401(k) Retirement Plan with a generous company match
  • Simple IRA
  • Medical and Dependent Care Flex Spending Accounts
  • $150 Initial Scrub Allowance, $50/year Continued Allowance

Join us at Finney's Institutional Pharmacy and become a valuable member of our dedicated team committed to providing exceptional customer service in the healthcare industry. Apply now and be part of our mission to make a difference in the lives of our patients and community.

EEOC Statement

We are an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

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