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Symbria

LTC Pharmacy Adjudication Technician

Symbria

. Communicate with communities regarding expensive, non-formulary, and incomplete medication orders .

Posted 11/2/2026full-timeRemote • United StatesJuniorWebsite

Core Competencies

Role fit
Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in pharmacy operations, including medication order management, insurance billing, and patient account maintenance. Proficient in data entry and communication with community management, ensuring effective collaboration and customer service.

Highest-signal resume keywords
Pharmacy Technician LicenseData Entry ExperiencePrescription Billing ExperienceCustomer Service SkillsKnowledge of Brand/Generic Drugs

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills
Data EntryMedication Order ManagementInsurance BillingClaim Denial ResolutionRecord KeepingPrior Authorization ReviewFormulary Changes PreparationPatient Account MaintenanceMedication Alternatives EducationCommunication with Pharmacists
Soft Skills
Excellent Customer ServiceInterpersonal SkillsVerbal Communication SkillsWritten Communication SkillsOrganizational Skills
Tools & Technologies
Microsoft OfficeWordExcelOutlookElectronic Claims Submission
Certifications & Qualifications
Pharmacy Technician Certification (CPhT)State Licensure in IllinoisState Licensure in Massachusetts
Industry Keywords
Medicare D RejectionsNon-Formulary MedicationsCommunity CommunicationPatient LiaisonPharmacy Operations

About the role

Key responsibilities & impact
  • Communicate with communities regarding expensive, non-formulary, and incomplete medication orders
  • Educate communities on less expensive medication alternatives identified by staff pharmacists
  • Keep detailed records of orders requiring community communication
  • Follow up with communities when medications have not been changed or clarified
  • Communicate professionally with community management staff by phone or email
  • Assist with order data entry and answer data entry department phone calls
  • Review Medicare D rejections and prior authorizations
  • Coordinate with pharmacists or physicians to adjudicate claims
  • Prepare for formulary changes with designated operations staff
  • Perform insurance and billing clerical duties
  • Review and maintain patient account information
  • Prepare and submit electronic or paper claims to third parties
  • Identify and resolve claim denials
  • Act as liaison between patients and third parties
  • Collaborate with team members and supervisors to share best practices
  • Provide backup support to other pharmacy departments as needed
  • Perform other assigned duties

Requirements

What you’ll need
  • High School diploma or general education degree (GED)
  • Pharmacy Technician License and/or Certification (CPhT) as per State requirements
  • Must be licensed in Illinois and Massachusetts within 60 days of hire
  • Data entry experience; minimum one year
  • Excellent customer service, interpersonal, verbal and written communication skills
  • General computer knowledge including Microsoft Office: Word, Excel, and Outlook
  • Ability to maintain organization, multi-task and prioritize to manage assignments/projects
  • Strong knowledge of Brand/Generic drugs and medical terminology
  • Must currently live in a state Symbria Rx Services is licensed in: AZ, CO, FL, IL, IN, KS, MA, MI, MO, PA, OH, WI
  • High-speed internet access through a cable or fiber provider; minimum connection and latency requirements based on connected devices
  • Prescription billing experience; minimum one year preferred

Benefits

Comp & perks
  • Competitive pay, aligned with market guidelines
  • Full Benefits Package, including very generous paid time off plans
  • Professional liability coverage
  • 100% employer-funded ESOP retirement plan
  • 401(k) and Roth(k) plans
  • Continuing education
  • Credit union membership
  • 100% employee-owned company