Pharmacy Claims Adjudication Specialist

Onco360 Oncology Pharmacy; Albuquerque (NM); On-site; USD 26,174 - 42,705; Full time

Benefits offered by this job

401k with a match

Paid Time Off and Paid Holidays

Tuition Reimbursement

Company paid benefits – life; and短 and

Job summary

Onco360 Oncology Pharmacy in Albuquerque, NM seeks a Pharmacy Claims Adjudication Specialist for a remote/hybrid role. Must hold active NM Pharmacy Technician credentials. Starting salary from $22.00/hour with a $5,000 sign-on bonus for hires before Aug 31, 2026.

Full-time with 401k, PTO, tuition reimbursement, and company-paid benefits available. Experience in pharmacy claims adjudication, medical billing, or benefits verification is required.

Qualifications

• Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification, Pharmacy Claims Adjudication
• Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician, Specialty pharmacy experience
• Required: Registration with Board of Pharmacy as required by state law
• Desired: Certified Pharmacy Technician (PTCB)

Responsibilities

• Education/Learning Experience: Required: 2+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience
• Desired: 3+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience
• Skills/Knowledge: Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills
• Desired: Knowledge of Foundation Funding, Specialty pharmacy experience
• Licenses/Certifications: Required: Registration with Board of Pharmacy as required by state law
• Desired: Certified Pharmacy Technician (PTCB)
• Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skills

Skills

Pharmacy/NDC billing

Pharmacy claims resolution

PBM contracts

Medicare/Medicaid knowledge

NCPDP rejection resolution

Benefit coordination

Pharmacy terminology

Math and analytics

Typing skills

Education

High School Diploma or GED

Associate degree or equivalent program

Certified Pharmacy Technician

Job description

Position:Pharmacy Claims Adjudication Specialist

Location: Albuquerque, NM

Job Id:5446

# of Openings:1

We are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy working in Mountain Time Zone.This will be a Full-Time position. This is a remote/hybrid opportunity,

Full-Time position may work remotely but MUST HAVE ACTIVE NEW MEXICO PHARMACY TECHNICIAN credentials from the State Board of Pharmacy.

Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers.

Starting salary from $22.00 an hour and up

Sign-On Bonus: $5,000 for employees starting before August 31, 2026.

We offer a variety of benefits including:

• 401k with a match
• Paid Time Off and Paid Holidays
• Tuition Reimbursement
• Company paid benefits – life; and short and long-term disability

Pharmacy Adjudication Specialist

Pharmacy Adjudication Specialist Qualifications and Responsibilities...

• Education/Learning Experience
  • Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification, Pharmacy Claims Adjudication
  • Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician, Specialty pharmacy experience
• Work Experience
  • Required: 2+ years experience in Pharmacy/Healthcare Setting orpharmacy claims experience
  • Desired: 3+ yearsexperience in Pharmacy/Healthcare Setting orpharmacy claims experience
• Skills/Knowledge
  • Required:Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills
  • Desired: Knowledge of Foundation Funding, Specialty pharmacy experience
• Licenses/Certifications
  • Required:Registration with Board of Pharmacy as required by state law
  • Desired:Certified Pharmacy Technician (PTCB)
• Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skills