Pharmacy Claims Adjudication Supervisor - Leadership

Onco360 Oncology Pharmacy; Houston (TX); On-site; USD 54,000 - 66,000; Full time

Benefits offered by this job

401k with a match

Paid Time Off

Paid Holidays

Quarterly Incentive Bonuses

Tuition Reimbursement

Company paid life insurance; short and

long-term disability

Job summary

Onco360 Pharmacy is seeking a Pharmacy Adjudication Supervisor in Houston, TX. The role leads the adjudication team, ensuring accurate pharmacy claims, resolving third-party rejections, and coordinating benefits to avoid delays in medication delivery.

The ideal candidate has 4+ years in pharmacy adjudication or related fields, with leadership experience and strong knowledge of PBM contracts and insurance processes. Monday–Friday, 9:30 am–6:00 pm CST, full-time.

Qualifications

• NDC medication billing and PBM/insurance contracts knowledge.
• Experience with Medicare/Medicaid and commercial insurance.
• Strong numerical, analytical, and detail-oriented skills.

Responsibilities

• Oversee adjudication staff to ensure accuracy of claims.
• Resolve third-party rejections and coordination of benefits.
• Contact insurers to resolve rejections and follow up on prior authorizations.

Skills

NDC medication billing

PBM and contracts

Medicare/Medicaid knowledge

Insurance claim resolution

Analytical skills

Education

High School Diploma or GED

Associates or Bachelor's Degree

Job description

Onco360 Pharmacy is seeking a Pharmacy Adjudication Supervisor in Houston, TX. The role leads the adjudication team, ensuring accurate pharmacy claims, resolving third-party rejections, and coordinating benefits to avoid delays in medication delivery.

The ideal candidate has 4+ years in pharmacy adjudication or related fields, with leadership experience and strong knowledge of PBM contracts and insurance processes. Monday–Friday, 9:30 am–6:00 pm CST, full-time.