Pharmacy Claims Adjudication Coordinator

💰 $5,120 - $8,192 (Est.) 📍 Atlanta

Job Description

$20 - $22 an hour
Paid parental leave, Parental leave, 401(k), Health insurance, 401(k) matching, Paid time off, Vision insurance, Dental insurance, Employee assistance program, Paid holidays
Full-time
Smyrna, GA 30082
 
Profile insights
Find out how your skills align with the job description
Licenses

Do you have a valid Registered Pharmacy Technician license?
Certifications

Do you have a valid Pharmacy Technician Certification certification?
Skills

Do you have experience in Quality control?
Education

Do you have a High school diploma or GED?
 
Full job description
Remote- After training!

Do 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.

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. This position is primarily responsible for all adjudication of prescription claims which includes primary, secondary and tertiary insurance claims.

With your passion to help patients and your drive to make an impact on those you touch, you will lead a business unit to drive operational results and deliver world class customer service. Your experience, positive attitude and your drive to deliver results will help navigate the excitement of a fast-growing company and all the fun and excitement that comes with it. We have listed a few of your responsibilities below:

Accurately performs the billing and adjudication functions in Pioneer Rx.
Reviews, applies, and rectifies assignment of benefits claims for proper billing sequence, methods, and application.
Notifies Patient Care Coordinators of all exceptions and errors in a timely and productive manner.
Responsible for all communication to ensure that action items that were not processed as planned by the Patient Care Coordinators (PCC’s) are complete (any insurance rejections, prior authorizations, problems with patient packet assembly, etc.).
Checks cycle fill claims/patients for missing prescriptions and copay assistance options.
Enters and charges credit cards when applicable
Accurately works all insurance rejections that are found with all processing of claims.
Communication to the PA team and Pharmacy team when any exceptions and errors that effect these departments are found and not resolved.
Double checks accuracy of secondary and tertiary claims to ensure compliance to department policies and seeks copay and financial assistance for claims that qualify.
Double checks 340b compliance to SOP, P&P’s, and SOW’s.
Provides communication and follow-up on actions items that need approval from the Patient Care Coordinators and Pharmacy staff.
Holds claims that require further clarification and/or follow up from appropriate staff. 30
Performs daily Quality Check reporting to verify accuracy of the days processing of claims.
Runs and reviews various assigned reports daily, corrects claims identified as missed or incorrect, and notifies the Patient Care Coordinators of any exceptions and errors that cannot be resolved.
Applies for copay assistance for applicable drugs and price plans.
Performs QA functions on all claims in Pioneer Rx daily/weekly/monthly
General administrative support as assigned by manager. Provide back up to team members as needed
Requires a high school diploma or equivalent with a
Minimum of 2 years experience
Registered Pharmacy Technician in the state of GA (Must be Active)
Why Work for Us?

We offer competitive pay in a non-retail business setting, paid holidays, benefits, paid time off and a work/life balance. Not only that, we offer paid maternity leave, recognition programs, promotion opportunities, a comprehensive training program to enhance your career, and employee prescription discounts.

Our Core Values consist of ICARE; Integrity, Communication, Accountability, Relationships and Excellence, and we take pride in you embodying those traits. You will help write the next chapter in healthcare.

Curant Health is an equal opportunity employer.

We promote a team atmosphere that provides excellent opportunity for growth as well as work life balance.

Apply today!

Job Type: Full-time

Pay: $20.00 - $22.00 per hour

Benefits:

401(k)
401(k) matching
Dental insurance
Employee assistance program
Health insurance
Paid time off
Vision insurance
License/Certification:

Pharmacy Technician Certification (Required)
Ability to Commute:

Smyrna, GA 30082 (Required)
Work Location: In person

 
 
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💡 Quick Summary

Seeking a career-building opportunity? The Pharmacy Claims Adjudication Coordinator position is now open for candidates interested in the Lab Technician / Pharmacist Jobs sector. This role in Atlanta offers a professional environment and growth potential.

Requirement Snapshot: Candidates should possess basic communication skills, a proactive attitude, and the ability to work in a team. Experience in Lab Technician / Pharmacist Jobs is a plus.

Sponsored

Job Details

Company Name: Curant Health

Frequently Asked Questions

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The expected salary for Pharmacy Claims Adjudication Coordinator in Atlanta is $5,120 - $8,192 (Est.) per month. Actual compensation may vary based on experience and negotiation.
No, Pharmacy Claims Adjudication Coordinator is an on-site position based in Atlanta. Candidates must be able to commute or relocate to this location.
Basic communication skills, a proactive attitude, and the ability to work in a team are required for Pharmacy Claims Adjudication Coordinator. Previous experience in Lab Technician / Pharmacist Jobs is a plus. Freshers may also apply depending on the employer's requirements.
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