Lead Pharmacy Claims Adjudication Supervisor

Onco360; Louisville (KY); On-site; USD 54,000 - 66,000; Full time

Benefits offered by this job

Medical

Dental

Vision

401k match

PTO & Holidays

Bonuses

Tuition Reimbursement

Life Insurance

Disability

Job summary

Onco360 Pharmacy is seeking a Pharmacy Adjudication Supervisor to lead a claims adjudication team in a full-time role, with a 9:30 am–6:00 pm EST schedule. The role focuses on quality control, dispute resolution with insurers, and timely medication delivery while supporting a growing specialty program.

Ideal candidates have 4+ years in pharmacy adjudication with leadership experience, a high school diploma or GED, and preferably an associates or bachelor’s degree.

Qualifications

• High School diploma or GED with pharmacy/medical billing knowledge.
• 4+ years in pharmacy adjudication or equivalent; leadership experience.
• Desired: 5+ years experience and supervisor exposure.
• Desirable: Specialty pharmacy experience.

Responsibilities

• Supervise adjudication staff to maintain quality and timely processing.
• Collaborate with Pharmacy Operations to streamline dispensing workflows.
• Recruit, train, and coach staff; apply corrective action when needed.
• Oversee daily adjudication workflow and KPI reporting.
• Handle escalations for complex claim rejections and resolutions.
• Perform outreach to insurers to resolve third-party rejections.
• Ensure compliance with regulatory standards and company policies.

Skills

NDC billing

PBM contracts

Medicare/Medicaid knowledge

NCPDP claim resolution

Coordination of benefits

Interpersonal skills

Pharmacy terminology

Brand/generic names

Typing & math skills

Analytics

Education

High School Diploma or GED

Associates or Bachelor's Degree

Job description

Onco360 Pharmacy is seeking a Pharmacy Adjudication Supervisor to lead a claims adjudication team in a full-time role, with a 9:30 am–6:00 pm EST schedule. The role focuses on quality control, dispute resolution with insurers, and timely medication delivery while supporting a growing specialty program.

Ideal candidates have 4+ years in pharmacy adjudication with leadership experience, a high school diploma or GED, and preferably an associates or bachelor’s degree.