Remote Pharmacy Claims Adjudication Specialist

JobRx, Inc.; Hartford (CT); Hybrid; USD 52,000 - 60,000; Full time

Benefits offered by this job

Medical, Dental, Vision

401(k) with match

Paid Time Off and Paid Holidays

Tuition Reimbursement

Company-paid life insurance and disability benefits

Job summary

JobRx, Inc. is seeking a Pharmacy Adjudication Specialist for its Specialty Oncology pharmacy in Hartford, Connecticut. This full-time role offers potential remote work opportunities and involves managing pharmacy claims effectively while ensuring proper patient outreach and compliance with regulations.

Ideal candidates will have a High School Diploma or GED and at least two years of relevant experience in pharmacy or healthcare settings. Salary starts at $26 per hour with additional benefits.

Qualifications

• 2+ years experience in pharmacy/healthcare setting or pharmacy claims experience required.
• Knowledge of pharmacy terminology including sig codes, Roman numerals, brand/generic names of medication.
• Previous experience in pharmacy, medical billing, or benefits verification.

Responsibilities

• Adjudicate pharmacy claims accurately according to benefits coordination.
• Resolve third-party rejections and manage patient notifications regarding medication delivery delays.
• Perform outreach calls to patients to ensure timely medication shipments.

Skills

Pharmacy/NDC medication billing

Pharmacy claims resolution

Knowledge of Medicare, Medicaid, and commercial insurance

Basic math and analytical skills

Intermediate typing/keyboarding skills

Education

High School Diploma or GED

Associate degree or equivalent

Job description

JobRx, Inc. is seeking a Pharmacy Adjudication Specialist for its Specialty Oncology pharmacy in Hartford, Connecticut. This full-time role offers potential remote work opportunities and involves managing pharmacy claims effectively while ensuring proper patient outreach and compliance with regulations.

Ideal candidates will have a High School Diploma or GED and at least two years of relevant experience in pharmacy or healthcare settings. Salary starts at $26 per hour with additional benefits.