Remote Pharmacy Claims Adjudication Specialist

JobRx, Inc.; Columbus (OH); Hybrid; USD 50,000 - 60,000; Full time

Benefits offered by this job

Medical, Dental, Vision

401k with a match

Paid Time Off and Paid Holidays

Tuition Reimbursement

Company-paid life and disability benefits

Job summary

JobRx, Inc. is hiring a Pharmacy Adjudication Specialist based in Columbus, Ohio. The role involves adjudicating pharmacy claims, resolving third-party rejections, and ensuring accurate prescription deliveries. Ideal candidates will have a high school diploma, pharmacy technician registration, and at least 2 years of pharmacy or healthcare experience.

This full-time position offers the possibility to work remotely. A starting salary of $25.00 an hour is provided, along with a $5,000 sign-on bonus for early hires. Additional benefits include medical, dental, and vision coverage, along with a matching 401k.

Qualifications

• 2+ years of experience in a Pharmacy/Healthcare setting or pharmacy claims experience is required.
• Pharmacy Technician License/Registration with Board of Pharmacy is required.
• Strong understanding of pharmacy or healthcare-related knowledge.

Responsibilities

• Adjudicate pharmacy claims for prescriptions in active workflow.
• Resolve third-party rejections and obtain overrides if appropriate.
• Contact insurance companies to resolve claim issues.

Skills

Pharmacy/NDC medication billing

Pharmacy claims resolution

PBM and Medical contracts

Knowledge of Medicare and Medicaid

NCPDP claim rejection resolution

Basic math and analytical skills

Intermediate typing/keyboarding skills

Education

High School Diploma or GED

Pharmacy Technician License

Associate degree from a 2-year program

Job description

JobRx, Inc. is hiring a Pharmacy Adjudication Specialist based in Columbus, Ohio. The role involves adjudicating pharmacy claims, resolving third-party rejections, and ensuring accurate prescription deliveries. Ideal candidates will have a high school diploma, pharmacy technician registration, and at least 2 years of pharmacy or healthcare experience.

This full-time position offers the possibility to work remotely. A starting salary of $25.00 an hour is provided, along with a $5,000 sign-on bonus for early hires. Additional benefits include medical, dental, and vision coverage, along with a matching 401k.