Pharmacy Benefit Verifier – Oncology Support (Sign-On Bonus)

Onco360; Waltham (MA); On-site; USD 28,000 - 40,000; Full time

Benefits offered by this job

401k match

Paid time off

Paid holidays

Tuition reimbursement

Floating holiday

Referral incentive

Life insurance

Disability insurance

Job summary

Onco360 is seeking a Pharmacy Benefit Verification Specialist in Waltham, MA, to verify patient insurance benefits and load accurate data in CPR+ for pharmacy orders. The role focuses on coordination of benefits, test claims, and ensuring timely, precise benefit information for providers and patients.

The candidate should have 1+ year of pharmacy or benefit verification experience, with High School Diploma or GED, and ideally an Associate degree or PTCB certification. Relocation is not indicated.

Qualifications

• High School Diploma or GED required.
• 1+ year pharmacy or benefit verification experience required.
• Associate degree or equivalent program desirable; PTCB certification preferred.
• Experience with Medicare/Medicaid and commercial insurance advantageous.

Responsibilities

• Verify patient insurance benefits and ensure accurate loading in CPR+ system.
• Determine authorization requirements for medication coverage and enroll patients in copay programs.
• Communicate benefit information to pharmacy operations, providers and patients.
• Perform full benefits verification across pharmacy and medical benefits.
• Run test claims to obtain valid adjudication and guide dispensing."
• Assist with medical authorizations, LOAs, and TOAs as applicable.

Skills

Pharmacy insurance

Benefit verification

PBM contracts

Medicare knowledge

Medicaid knowledge

Insurance coordination

NDC billing

Typing/keyboard

Education

High School Diploma or GED

Associate degree or equivalent

PTCB certification (optional)

Specialty pharmacy experience (desired)

Tools

CPR+ system

Job description

Onco360 is seeking a Pharmacy Benefit Verification Specialist in Waltham, MA, to verify patient insurance benefits and load accurate data in CPR+ for pharmacy orders. The role focuses on coordination of benefits, test claims, and ensuring timely, precise benefit information for providers and patients.

The candidate should have 1+ year of pharmacy or benefit verification experience, with High School Diploma or GED, and ideally an Associate degree or PTCB certification. Relocation is not indicated.