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Credit Adjudication Jobs (NOW HIRING)

Analyze claims payment activity, funding, payment activity, adjudication outcomes, and ... Client Request for Funds/Credits * Provider Claim Payment Cycle Processing * Provider Recoupments

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... credit reports. * Experience preparing adjudicative recommendations regarding personnel suitability determinations. * Experience conducting supervisory reviews of completed adjudication reports and ...

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Credit Adjudication information

What are some of the key challenges faced by professionals in Credit Adjudication, and how can they be managed effectively?

One of the primary challenges in Credit Adjudication is balancing the need for thorough risk assessment with the demands of timely decision-making. Adjudicators must analyze complex financial information, assess applicants' creditworthiness, and ensure compliance with regulatory requirements—all while meeting tight deadlines. Staying current with lending policies and leveraging advanced credit analysis tools can help manage workload efficiently. Additionally, effective communication and collaboration with loan officers and risk teams are essential for resolving ambiguous cases and ensuring consistent decision quality.

Is credit analysis a good career?

Credit analysis is a stable career that involves evaluating the creditworthiness of individuals or businesses, often requiring strong analytical skills and knowledge of financial statements. It can lead to roles in banking, finance, or risk management, with opportunities for advancement and certification such as the CFA. The job typically involves working in an office environment with regular hours and the use of financial software tools.

What do credit adjudicators do?

Credit adjudicators evaluate loan applications and determine creditworthiness by analyzing financial information, credit reports, and supporting documents. They make decisions on approving or denying credit, often using specialized software and adhering to company policies and regulations.

What kind of jobs run credit checks?

Credit adjudication jobs often involve reviewing credit reports and financial histories to assess eligibility or risk, such as in lending, loan processing, or financial analysis roles. These positions typically require knowledge of credit reporting systems and may involve background checks or certifications related to financial services.

What is the difference between Credit Adjudication vs Credit Analyst?

AspectCredit AdjudicationCredit Analyst
Required credentialsTypically a bachelor's degree in finance, accounting, or related fieldUsually a bachelor's degree in finance, economics, or business
Work environmentFinancial institutions, lending companies, banksFinancial institutions, banks, credit agencies
Employer usageDecides on loan approvals based on creditworthinessAnalyzes credit data to assess risk and inform lending decisions

While both roles involve working with credit data, Credit Adjudication focuses on making final approval or denial decisions for loans, whereas Credit Analysts evaluate creditworthiness to support those decisions. Understanding these differences helps clarify career paths and job expectations in the credit industry.

What are the key skills and qualifications needed to thrive in Credit Adjudication, and why are they important?

To excel in Credit Adjudication, you need strong analytical skills, a solid understanding of credit risk principles, and typically a degree in finance, business, or a related field. Familiarity with credit scoring systems, financial analysis software, and regulatory compliance tools is often required. Attention to detail, sound judgment, and effective communication are vital soft skills for making balanced credit decisions and conveying outcomes clearly. These competencies ensure accurate risk assessments and support responsible lending practices that protect both the financial institution and its clients.

What is credit adjudication?

Credit adjudication is the process by which a financial institution evaluates a borrower's creditworthiness and decides whether to approve or deny a loan or credit application. This process involves reviewing the applicant's financial information, credit history, and ability to repay the debt. The goal is to assess the risk involved and ensure responsible lending decisions that protect both the lender and the borrower.

What is the highest paying job in credit?

In credit-related roles, senior positions such as Credit Director or Chief Credit Officer tend to have the highest salaries, often exceeding six figures annually. These roles require extensive experience, strong analytical skills, and often involve overseeing credit policies and risk management at an organizational level.
More about Credit Adjudication jobs
What states have the most Credit Adjudication jobs? States with the most job openings for Credit Adjudication jobs include:
What job categories do people searching Credit Adjudication jobs look for? The top searched job categories for Credit Adjudication jobs are:
Infographic showing various Credit Adjudication job openings in the United States as of July 2026, with employment types broken down into 83% Full Time, 13% Part Time, 2% Temporary, and 2% Contract. Highlights an 85% Physical, 4% Hybrid, and 11% Remote job distribution.
Sr. Associate Analyst, Pharmacy Collections

Sr. Associate Analyst, Pharmacy Collections

McKesson

Cary, NC • Hybrid

$30 - $31/hr

Full-time

Posted 19 days ago


McKesson rating

7.9

Company rating: 7.9 out of 10

Based on 208 frontline employees who took The Breakroom Quiz

47th of 86 rated pharmaceutical


Job description

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care.

What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you.

The Sr. Associate Analyst, Pharmacy Collections is responsible for managing high-volume portfolio of pharmacy adjudicated claims, including payer follow-up, denial research and resolution, underpayment review, credit balance management, and ensuring cash collections of such activities. This role works assigned accounts to secure timely and accurate reimbursement, reduce aging, resolve claim issues, and ensure compliance with payer, regulatory, and departmental productivity standards.

Location: This is a hybrid role with up to two days in office at our Cary, NC location.

Compensation: Target rate is between $30 and $31 an hour.

Key Responsibilities

  • Manage a high-volume portfolio of pharmacy adjudicated claims and perform timely follow-up on outstanding accounts to maximize cash collections and reduce aged receivables.

  • Research and resolve denials, underpayments, rejections, and payment variances by reviewing claim history, EOBs, remittance advice, payer guidelines, and supporting documentation.

  • Analyze account balances and reimbursement activity to identify root causes, escalate trends, and recommend corrective actions that improve collection performance and claim resolution.

  • Coordinate with payers, PBMs, internal billing teams, and cross-functional partners to resolve claim issues, support resubmissions, ensure adherence to timely filing and reimbursement requirements and maximize cash collections.

  • Manage credit balances, refund requests, and overpayment activity in accordance with contractual, regulatory, and legal requirements, including Medicare and Medicaid guidelines.

  • Serve as a subject matter resource for collection workflows, respond to process-related questions, and assist with first-level issue escalation and account resolution support.

  • Prepare clear account summaries, trend analysis, and recommendations for leadership to support issue resolution, process improvements, and operational decision-making.

  • Support implementation of new processes, pilots, and workflow enhancements, including knowledge transfer and training to team members as needed.

  • Monitor productivity and quality expectations while maintaining accurate documentation of collection activity, claim status, and account disposition.

Minimum Requirement

Degree or equivalent and typically requires 2+ years of relevant experience.

Education

Associate degree or higher in a related field, or an equivalent combination of education and relevant experience.

Critical Skills

  • 2+ years of high-volume pharmacy and/or medical accounts receivable, billing, and collections experience; senior-level or lead experience preferred.

  • Demonstrated experience working pharmacy adjudicated claims, interpreting EOBs and remittance advice, and performing detailed research on denials, underpayments, and outstanding balances.

  • Strong knowledge of payer guidelines, reimbursement practices, timely filing requirements, and credit balance or refund processes.

  • Ability to identify root causes, analyze trends, and resolve complex account issues independently with minimal supervision.

  • Highly organized, proactive, and able to manage multiple priorities in a fast-paced, high-volume environment.

  • Strong analytical, problem-solving, and communication skills with the ability to collaborate effectively across teams and with external payers.

  • Results-driven mindset focused on AR resolution, reimbursement accuracy, and continuous process improvement.

  • Knowledge of general accounting principles and proficiency in Microsoft Office Suite, including Outlook, Excel, Word, PowerPoint, Teams, and SharePoint.

We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, pleaseclick here.

Our Base Pay Range for this position

$24.83 - $41.39

McKesson has become aware of online recruiting-related scams in which individuals who are not affiliated with or authorized by McKesson are using McKesson's (or affiliated entities, like CoverMyMeds or RxCrossroads) name in fraudulent emails, job postings or social media messages. In light of these scams, please bear the following in mind:
McKesson Talent Advisors will never solicit money or credit card information in connection with a McKesson job application.


McKesson Talent Advisors do not communicate with candidates via online chatrooms or using email accounts such as Gmail or Hotmail. Note that McKesson does rely on a virtual assistant (Gia) for certain recruiting-related communications with candidates.

McKesson job postings are posted on our career site: careers.mckesson.com.

McKesson is an Equal Opportunity Employer

McKesson provides equal employment opportunities to applicants and employees, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, genetic information, or any other legally protected category. For additional information on McKesson's full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page.

McKesson is committed to being an Equal Employment Opportunity Employer and offers opportunities to all job seekers including job seekers with disabilities. If you need a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to (United States) Disability_Accommodation@McKesson.com or (Canada) Accessibility@mckesson.ca. Resumes or CVs submitted to this email box will not be accepted.

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