Remote Pharmacy Claims Adjudication Pro – $5k Sign-On Bonus

Onco360; Pittsburgh (Allegheny County); Remote; USD 48,000 - 60,000; Full time

Benefits offered by this job

401k with match

Paid Time Off and Holidays

Tuition Reimbursement

Company paid life & disability

Job summary

Onco360 is seeking a Pharmacy Claims Adjudication Specialist in the Pittsburgh, PA area to adjudicate pharmacy claims and manage insurance coordination.

The role requires active Pennsylvania Pharmacy Technician credentials and offers full-time employment with potential remote work options. The starting hourly rate and a $5,000 sign-on bonus for hires before December 31, 2026 are highlighted along with benefits like 401k, PTO, and tuition reimbursement.

Qualifications

• Requires High School Diploma or GED; Pharmacy/Healthcare claims exp preferred.
• Associate degree or technical program desired; Pharmacy tech certification helpful.
• Experience in pharmacy claims adjudication and COB coordination.
• Licensed Pharmacy Technician as required by state law; Pennsylvania credentials preferred.

Responsibilities

• Adjudicate pharmacy claims and review responses for accuracy.
• Resolve third-party rejections and obtain overrides when appropriate.
• Notify patients about delays due to insurance claims and coordinate delivery.
• Ensure accurate patient setup in CPR+ with demographic and insurance data.
• Communicate with insurers to resolve rejections and reschedule shipments as needed.
• Support billing and copay processes to ensure proper charges before shipment.

Skills

Claims adjudication

Customer service

Interpersonal skills

Attention to detail

Education

High School Diploma or GED

Associate degree or equivalent

Tools

CPR+ system

Job description

Onco360 is seeking a Pharmacy Claims Adjudication Specialist in the Pittsburgh, PA area to adjudicate pharmacy claims and manage insurance coordination.

The role requires active Pennsylvania Pharmacy Technician credentials and offers full-time employment with potential remote work options. The starting hourly rate and a $5,000 sign-on bonus for hires before December 31, 2026 are highlighted along with benefits like 401k, PTO, and tuition reimbursement.