Hybrid Pharmacy Claims Adjudication Specialist

Onco360 Oncology Pharmacy; Louisville (KY); Híbrido; USD 44.000 - 52.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical Insurance

Dental Insurance

Vision Insurance

401k with match

Paid Time Off

Paid Holidays

Tuition Reimbursement

Life Insurance

Disability Insurance

Descripción de la vacante

Onco360 Oncology Pharmacy in Louisville, KY is hiring a Pharmacy Adjudication Specialist for a full-time, hybrid role within driving distance. Shifts run 8am–8pm; starting pay is $21/hour with a $5,000 sign-on bonus for hires before Dec 31, 2026.

Benefits include medical, dental, vision, 401k match, PTO, holidays, tuition reimbursement, and company-paid life and disability coverage. Responsibilities include adjudicating claims, resolving COB rejections, patient outreach about delays, and

Formación

• Must have HS diploma or GED; pharmacy/claims experience preferred.
• 2+ years in pharmacy/healthcare setting or pharmacy claims experience required.
• Knowledge of Medicare, Medicaid and commercial insurance.
• Familiarity with pharmacy terminology and rebates/benefits processes.

Responsabilidades

• Adjudicate pharmacy claims and review responses for accuracy.
• Conduct outreach to providers/patients regarding claim status and delivery timelines.
• Maintain patient setup accuracy in CPR+ with demographics and insurance.
• Resolve third-party rejections; obtain overrides when appropriate.
• Communicate copay information and coordinate with patients on payments.

Conocimientos

Pharmacy claims

Claims adjudication

Medicare/Medicaid knowledge

NCPDP knowledge

Communication skills

Educación

High School Diploma or GED

Associate degree (preferred)

Herramientas

CPR+ system

Descripción del empleo

Onco360 Oncology Pharmacy in Louisville, KY is hiring a Pharmacy Adjudication Specialist for a full-time, hybrid role within driving distance. Shifts run 8am–8pm; starting pay is $21/hour with a $5,000 sign-on bonus for hires before Dec 31, 2026.

Benefits include medical, dental, vision, 401k match, PTO, holidays, tuition reimbursement, and company-paid life and disability coverage. Responsibilities include adjudicating claims, resolving COB rejections, patient outreach about delays, and