Pharmacy Benefits Verification Specialist

Onco360 Oncology Pharmacy; Scottsdale (AZ); On-site; USD 27,276 - 38,848; Full time

Benefits offered by this job

401(k) with match

Paid Time Off and Paid Holidays

Tuition Reimbursement

Floating Holiday

Referral Incentive

Paid Life and Disability Insurance

Job summary

Onco360 Oncology Pharmacy in Scottsdale, AZ is looking for a Patient Benefit Verification Specialist. This role involves verifying patient insurance information, performing benefits verification, and assisting with copay card programs.

Candidates should have at least 1 year of pharmacy experience, a high school diploma, and strong communication skills. The position offers a starting salary of $24 per hour and a $5,000 sign-on bonus for eligible employees.

Qualifications

• 1+ year pharmacy or benefit verification experience required.
• Previous experience in Pharmacy, Medical Billing, or Benefits Verification is essential.
• Desirable candidates will have specialty pharmacy experience.

Responsibilities

• Investigate, review, and load accurate patient insurance information.
• Perform full benefits verification for pharmacy benefits.
• Enroll eligible patients in copay card assistance programs.
• Facilitate process for requesting medical authorizations and claims.
• Maintain compliance with laws and company standards.

Skills

Pharmacy insurance and benefit verification

Knowledge of Medicare and Medicaid

Basic math and analytical skills

Excellent verbal and written communications

Detail-oriented and strong time-management

Education

High School Diploma or GED

Associate degree or equivalent

Job description

Location: Scottsdale, AZ

Job Id: 5283

# of Openings: 4

Shift: Monday through Friday between 8:00 AM and 8:00 PM

Starting Salary: $24 per hour and up

Sign‑On Bonus: $5,000 for employees starting before July 31, 2026

Benefits:

• 401(k) with match
• Paid Time Off and Paid Holidays
• Tuition Reimbursement
• Floating Holiday
• Referral Incentive
• Paid Life, and short & long-term disability insurance

Responsibilities

• Investigate, review, and load accurate patient insurance information, including medical and pharmacy coverage.
• Assign coordination of benefits, run test claims to obtain a valid insurance response on patient medications, and investigate/identify authorization requirements needed to obtain medication coverage.
• Enroll eligible patients in copay card assistance programs.
• Ensure accurate benefit documentation is made for all prescription orders.
• Practice first‑call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests.
• Provide thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding benefit information.
• Ensure complete and accurate patient setup in CPR+ system, including patient demographic and insurance information.
• Perform full benefits verification on patients for pharmacy benefits and/or medical benefit utilizing electronic resources and E1 check.
• Run test claims at each licensed pharmacy site to obtain a valid claim response and determine optimal reimbursement, then document outcome of benefits review in CPR+ system to be used by operations and ensure the order is assigned to the appropriate dispensing pharmacy.
• Facilitate process for requesting medical authorizations, LOAs, and TOAs for applicable commercial, Medicaid, and Medicare, or facility medication claims.
• Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws.
• Contribute to team effort by accomplishing related tasks as needed and other duties as assigned.
• Conduct duties in accordance with the company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.

Qualifications

• Education/Learning Experience:
  • Required: High School Diploma or GED. Previous experience in Pharmacy, Medical Billing, or Benefits Verification.
  • Desired: Associate degree or equivalent program from a 2‑year program or technical school; Certified Pharmacy Technician (PTCB); specialty pharmacy experience.
• Work Experience:
  • Required: 1+ year pharmacy or benefit verification experience.
  • Desired: 3+ years pharmacy or benefit verification experience.
• Skills/Knowledge:
  • Pharmacy insurance and benefit verification, PBM and medical contracts, knowledge of Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, pharmacy or healthcare-related knowledge, pharmacy terminology including sig codes, Roman numerals, brand/generic names of medication, basic math and analytical skills, intermediate typing/keyboarding skills.
• Independent worker with good interpersonal skills, excellent verbal and written communications, ability to work independently, meet deadlines, be flexible, detail‑oriented, and strong time‑management skill.

Onco360 is a closed‑door specialty pharmacy that focuses on patients undergoing cancer treatment. We strive to meet and exceed their needs.