Pharmacy Technician - Claims Adjudication Coordinator

Do you dream of a great career with a great company where you can make an impact and help people?

We are committed to improving the lives of patients we serve while supporting our employees. Curant means CARE, reflecting our dedication.

Curant Health is recognized as one of Inc.'s fastest growing healthcare companies, honored by the Georgia Fast 40 and Atlanta Business Chronicle Trendsetters awards annually since 2013. Our medication management programs improve outcomes while reducing healthcare costs for patients.

As a Claims Adjudication Coordinator, you will be responsible for adjudicating prescription claims including primary, secondary, and tertiary insurance claims primarily using Pioneer Rx.

Your role includes:

• Performing billing and adjudication functions accurately in Pioneer Rx.
• Reviewing and rectifying benefit claims for proper billing sequence and application.
• Coordinating with Patient Care Coordinators (PCCs) on exceptions and errors.
• Managing communications to ensure unresolved action items (insurance rejections, prior authorizations, patient packet issues) are completed.
• Checking claims for missing prescriptions and copay assistance.
• Processing credit card charges when applicable.
• Resolving insurance rejections and notifying relevant teams.
• Ensuring secondary and tertiary claims comply with departmental policies and finding copay/financial assistance as appropriate.
• Verifying 340b compliance with SOPs and policies.
• Following up on approvals needed from PCCs and pharmacy staff.
• Holding claims needing further clarification.
• Conducting daily quality check reporting and reviewing claims.
• Applying for copay assistance for eligible drugs.
• Supporting administrative tasks and backup to team members as needed.

Requirements:

• High school diploma or equivalent.
• Minimum 2 years of experience.
• Active Registered Pharmacy Technician license in the state of Georgia.

Benefits:

• Competitive pay in a non-retail setting.
• Paid holidays and time off.
• Health, dental, and vision insurance.
• 401(k) with matching.
• Employee assistance program.
• Paid maternity leave.
• Recognition programs and promotion opportunities.
• Comprehensive training and employee prescription discounts.

Our Core Values: Integrity, Communication, Accountability, Relationships, Excellence.

We promote a collaborative team environment with opportunities for growth and work-life balance.

Job Type: Full-time

Location: In person at Smyrna, GA office

Pay: $22.00 per hour

Apply today and help shape the future of healthcare!