Remote Pharmacy Benefits Verifier – Oncology Specialty

Onco360; Pittsburgh (Allegheny County); Hybrid; USD 50,000 - 62,000; Full time

Benefits offered by this job

401k with match

Paid Time Off and Holidays

Tuition Reimbursement

Floating Holiday

Referral Incentive

Paid Life and disability insurance

Job summary

Onco360 is seeking a Pharmacy Benefit Verification Specialist in Pittsburgh, PA. The role focuses on verifying and loading patient insurance information for pharmacy and medical benefits, and coordinating authorizations to ensure coverage for oncology medications.

Responsibilities include running test claims, documenting outcomes in CPR+ and ensuring accurate patient data. Prior pharma verification experience and PA Pharmacy Technician credentials are required, with benefits including a sign-on

Qualifications

• 1+ years pharmacy or benefits verification experience.
• Knowledge of PBM contracts and medical coverage.
• Experience with NCPDP claims and denials resolution.

Responsibilities

• Investigate, review, and load accurate patient insurances (medical and pharmacy).
• Identify coordination of benefits and run test claims to obtain valid responses.
• Ensure patient setup in CPR+ with demographics and insurance data.
• Perform full benefits verification for pharmacy and medical benefits.
• Document outcomes of benefits review and route orders to dispensing site.
• Facilitate medical authorizations, LOAs, and TOAs for applicable claims.
• Maintain a safe, compliant pharmacy environment and patient confidentiality.
• Collaborate with team and complete related tasks as needed.
• Adhere to company policies, ethics, and applicable laws.

Skills

Pharmacy benefit verification

PBM and medical contracts

Medicare/Medicaid knowledge

NCPDP claim processing

Education

High School Diploma or GED

Associate degree or PTCB preferred

PTCB certification

Tools

CPR+ system

Job description

Onco360 is seeking a Pharmacy Benefit Verification Specialist in Pittsburgh, PA. The role focuses on verifying and loading patient insurance information for pharmacy and medical benefits, and coordinating authorizations to ensure coverage for oncology medications.

Responsibilities include running test claims, documenting outcomes in CPR+ and ensuring accurate patient data. Prior pharma verification experience and PA Pharmacy Technician credentials are required, with benefits including a sign-on