Remote Pharmacy Claims Adjudication Specialist

Onco360; Indianapolis (IN); Hybrid; USD 34,000 - 44,000; Full time

Benefits offered by this job

401k match

Paid time off

Paid holidays

Tuition reimbursement

Life insurance

Short and long-term disability

Job summary

Onco360 Pharmacy is seeking a Pharmacy Claims Adjudication Specialist in Indianapolis, IN. The role involves adjudicating pharmacy claims, resolving third-party rejections, and ensuring accurate patient data in CPR+.

The position requires Indiana Pharmacy Technician credentials, with shift times between 8am and 8pm and a starting hourly salary of $25.00 plus a $5,000 sign-on bonus for those joining before December 31st, 2026.

Qualifications

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

Responsibilities

• Adjudicates pharmacy claims for active workflow and reviews responses for accuracy.
• Resolve third-party rejections and obtain overrides when appropriate.
• Contact insurance companies to resolve rejections to allow timely shipping.
• Perform outreach calls to patients/providers for delays in medication delivery.
• Ensure copay cards apply only to eligible patients.
• Maintain accurate patient setup in CPR+ including demographics and insurance.
• Assist team with management of electronically adjudicated claims and copay collection.
• Serve as customer service liaison regarding financial responsibility before shipments.
• Document and submit requests for Patient Refunds when appropriate.
• Adhere to Code of Business Conduct and company policies.

Skills

Pharmacy billing

Claims resolution

PBM contracts

Medicare/Medicaid knowledge

NCPDP rejection resolution

Coordination of benefits

Pharmacy terminology

Typing skills

Education

High School Diploma or GED

Associate degree or equivalent

Certified Pharmacy Technician

Tools

CPR+ system

Job description

Onco360 Pharmacy is seeking a Pharmacy Claims Adjudication Specialist in Indianapolis, IN. The role involves adjudicating pharmacy claims, resolving third-party rejections, and ensuring accurate patient data in CPR+.

The position requires Indiana Pharmacy Technician credentials, with shift times between 8am and 8pm and a starting hourly salary of $25.00 plus a $5,000 sign-on bonus for those joining before December 31st, 2026.