LTC Pharmacy Adjudication Technician

This is a fully remote position, open to applicants in Arizona, +10 more states.

📋 Description

• Engage with communities regarding costly, non-formulary, and incomplete medication requests.

• Inform communities about more affordable medication alternatives identified by staff pharmacists.

• Maintain comprehensive records of orders that necessitate communication with communities.

• Follow up with communities when medications have not been modified or clarified.

• Communicate professionally with community management teams via phone or email.

• Assist with order data entry and respond to phone calls from the data entry department.

• Review Medicare D rejections and prior authorization requests.

• Collaborate with pharmacists or physicians to resolve claims.

• Prepare for formulary modifications with designated operations personnel.

• Execute clerical duties related to insurance and billing.

• Review and uphold patient account details.

• Prepare and submit electronic or paper claims to third-party entities.

• Identify and address claim denials.

• Serve as a liaison between patients and third-party organizations.

• Work with team members and supervisors to exchange best practices.

• Provide backup assistance to other pharmacy departments as required.

• Carry out other assigned responsibilities.

⛳️ Requirements

• High School diploma or equivalent general education degree (GED).

• Pharmacy Technician License and/or Certification (CPhT) as mandated by State regulations.

• Must obtain licensure in Illinois and Massachusetts within 60 days of employment.

• Minimum of one year of data entry experience.

• Exceptional customer service, interpersonal, verbal, and written communication abilities.

• General computer proficiency, including Microsoft Office: Word, Excel, and Outlook.

• Capability to stay organized, multitask, and prioritize effectively to handle assignments/projects.

• Strong understanding of Brand/Generic medications and medical terminology.

• Must currently reside in a state where Symbria Rx Services is licensed: AZ, CO, FL, IL, IN, KS, MA, MI, MO, PA, OH, WI.

• High-speed internet access via a cable or fiber provider; minimum connection and latency requirements based on connected devices.

• At least one year of prescription billing experience preferred.

🏝️ Benefits

• Competitive compensation, consistent with market standards.

• Comprehensive Benefits Package, including very generous paid time off plans.

• Professional liability insurance coverage.

• 100% employer-funded ESOP retirement plan.

• 401(k) and Roth(k) plans available.

• Continuing education opportunities.

• Credit union membership.

• 100% employee-owned organization.