Remote Pharmacy Claims Adjudication Specialist

Onco360; Albuquerque (NM); Hybrid; USD 25,000 - 36,000; Full time

Benefits offered by this job

401k with match

Paid Time Off & Holidays

Tuition Reimbursement

Life and disability insurance

Job summary

Onco360 is seeking a Pharmacy Claims Adjudication Specialist in Albuquerque, NM. This full-time, remote/hybrid role requires NM Pharmacy Technician credentials and offers a starting hourly rate with a sign-on bonus for early applicants.

The specialist adjudicates pharmacy claims, reviews responses for accuracy, and communicates with payers and patients to ensure timely delivery of medications. Onco360 provides benefits including 401k, PTO, tuition reimbursement, and disability coverage.

Qualifications

• High School Diploma or GED; experience in Pharmacy, Medical Billing, or Benefits Verification.

Responsibilities

• Adjudicate pharmacy claims and review claim responses for accuracy.
• Resolve third-party rejections and obtain overrides when appropriate.
• Conduct patient outreach regarding delays due to insurance claims.

Skills

Pharmacy claims billing

PBM contracts

Medicare knowledge

Medicaid knowledge

Coordination of benefits

Customer service

Basic math & analytics

Typing speed

Pharmacy terminology

Communication skills

Education

High School Diploma or GED

Associate degree or equivalent

Certified Pharmacy Technician

Tools

CPR+ system

Job description

Onco360 is seeking a Pharmacy Claims Adjudication Specialist in Albuquerque, NM. This full-time, remote/hybrid role requires NM Pharmacy Technician credentials and offers a starting hourly rate with a sign-on bonus for early applicants.

The specialist adjudicates pharmacy claims, reviews responses for accuracy, and communicates with payers and patients to ensure timely delivery of medications. Onco360 provides benefits including 401k, PTO, tuition reimbursement, and disability coverage.