Pharmacy Technician – Claims Adjudication Coordinator Position Available In Cobb, Georgia

Pharmacy Technician – Claims Adjudication Coordinator Curant Health Smyrna, GA 30082 • Hybrid work

JOIN A LEADING HEALTHCARE COMPANY

You dream of a great career with a great company – where you can make an impact and help people. We dream of giving you the opportunity to do just this. What helps set Curant Health apart?!

FULL TIME POSITIONS, NO NIGHTS, NO WEEKENDS, PAID HOLIDAYS AND EMPLOYEE BENEFITS!

Yes, that’s correct. We are not only committed to improving the lives of patients we serve, but yours as well. Curant means CARE, and that is just what we do. Our culture of caring is evident by being recognized as one of Inc.’s fastest growing healthcare companies, receiving the Georgia Fast 40 and Atlanta Business Chronicle Trendsetters awards every year since 2013. Our medication management programs and processes are proven to improve outcomes while reducing overall healthcare costs for our patients. Curant Health is searching for a Claims Adjudication Coordinator to join its team in Smyrna, GA.

Position Summary:

The Claims Adjudication Coordinator is responsible for the adjudication of prescription claims, including primary, secondary, and tertiary insurance. This role ensures prescription claims are processed efficiently and accurately, supporting both the Pharmacy and Patient Engagement teams. The coordinator will be cross-trained in various functions critical to the prescription fulfillment process from intake to delivery and must be detail-oriented, collaborative, and proactive in resolving billing-related issues.

Essential Duties and Responsibilities:

Core duties and responsibilities include the following. Other duties may be assigned as needed. Accurately perform billing and adjudication functions in PioneerRx. Resolve all claim-related issues and rebill claims electronically within the appropriate billing window. Check cycle fill claims/patients for missing prescriptions and apply available copay assistance options. Apply for copay card assistance for eligible medications and price plans. Accurately process insurance rejections and work through claim resolution. Communicate unresolved issues to Prior Authorization and Patient Engagement teams and follow up on outstanding action items. Collaborate with other departments via MedPlan to resolve billing and copay concerns. Validate accuracy of secondary and tertiary claims and seek financial support for qualified claims. Verify drug stock usage (DataRx, Rx, and 340B) in line with SOPs, policies, and work standards. Place claims on hold that require clarification or follow-up. Analyze and process daily, weekly, and monthly reports to confirm accuracy in claims billing including correct stock, quantity, day supply, payer(s), copay, and profitability. Complete all required CEUs to maintain licensure and additional training assigned by Curant Health. Meet or exceed departmental productivity and quality performance metrics. Maintain compliance with applicable standards including URAC, ACHC, NABP, and other specialty pharmacy accreditation guidelines.

Additional Responsibilities:

Provide general administrative support as needed. Offer backup support to team members. Perform other duties as assigned by supervisor.

Qualifications:

Education & Certifications:

High school diploma or equivalent required. Must be a registered Pharmacy Technician in the applicable state(s); licensing in GA PTCB certification is a plus but not required.

Experience:

At least two (2) years of experience in a retail pharmacy setting preferred. Medical billing experience preferred but not required. Familiarity with 340B program a plus. Must understand and adhere to HIPAA and patient confidentiality regulations.

Job Type:

Full-time Pay:

$21.00 – $22.00 per hour

Benefits:

401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance

Schedule:

Day shift

License/Certification:

Pharmacy Technician Certification (GA) (Required) Ability to

Commute:

Smyrna, GA 30082 (Required)

Work Location:

Hybrid remote in Smyrna, GA 30082