Remote/Hybrid Pharmacy Adjudication Specialist (MT)

Onco360 Oncology Pharmacy

Albuquerque (NM)

Hybrid

USD 46,000 - 70,000

Full time

38 hours ago

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Benefits offered by this job

Medical

Dental

Vision

401k match

Paid time off

Job summary

Onco360 Oncology Pharmacy is seeking a Pharmacy Adjudication Specialist in a remote/hybrid role with Mountain Time scheduling. The position requires active New Mexico Pharmacy Technician credentials and offers a starting rate of $22.00 per hour plus a $5,000 sign-on bonus for hires before 12/31/2026.

Responsibilities include adjudicating claims, resolving third-party rejections, and coordinating with insurance providers to ensure timely shipments while maintaining patient confidentiality and

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

Responsibilities

Adjudicate pharmacy claims and review claim responses for accuracy.
Ensure patient outreach regarding delays due to insurance claim rejections.
Contact insurance companies to resolve third-party rejections and perform outreach to schedule deliveries.

Skills

Pharmacy claims

NCPDP

Coordination of benefits

Medicare knowledge

PBM contracts

Pharmacy terminology

Basic math

Typing

Education

High School Diploma or GED

Associate degree

Certified Pharmacy Technician (PTCB)

Tools

CPR+ system

Job description

Responsibilities include adjudicating claims, resolving third-party rejections, and coordinating with insurance providers to ensure timely shipments while maintaining patient confidentiality and

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