Remote Oncology Pharmacy Claims Adjudication Specialist

Onco360 Oncology Pharmacy; Columbus (OH); Remote; USD 32,000 - 39,000; Full time

Benefits offered by this job

Medical

Dental

Vision

401k match

PTO & Holidays

Tuition Reimbursement

Life insurance

Disability

Job summary

Onco360 Pharmacy is seeking a Pharmacy Adjudication Specialist to join our specialty oncology team. This full-time role may be performed remotely but requires active Ohio Pharmacy Technician credentials from the State Board of Pharmacy.

Shift times are between 8am and 8pm, with a $5,000 sign-on bonus for employees starting before December 31st, 2026. Key duties include adjudicating pharmacy claims, reviewing claim responses for accuracy, resolving third-party rejections, contacting insurers, and

Qualifications

• Pharmacy claims adjudication experience.
• Knowledge of formularies and insurance workflows.
• Pharmacy terminology including sig codes and numerals.

Responsibilities

• Adjudicate pharmacy claims for prescriptions in active workflow.
• Review claim responses for accuracy before acceptance.
• Resolve third-party rejections and obtain overrides when appropriate.
• Contact insurers to resolve rejections and inform patients of delays.

Skills

Pharmacy billing

PBM contracts

Medicare/Medicaid

NCPDP rejection resolution

Coordination of benefits

Basic math & analytics

Typing

Education

High School Diploma or GED

Associate degree

Certified Pharmacy Technician

Tools

CPR+ system

Job description

Onco360 Pharmacy is seeking a Pharmacy Adjudication Specialist to join our specialty oncology team. This full-time role may be performed remotely but requires active Ohio Pharmacy Technician credentials from the State Board of Pharmacy.

Shift times are between 8am and 8pm, with a $5,000 sign-on bonus for employees starting before December 31st, 2026. Key duties include adjudicating pharmacy claims, reviewing claim responses for accuracy, resolving third-party rejections, contacting insurers, and