Remote Pharmacy Claims Adjudication Specialist

Onco360 Oncology Pharmacy

Salt Lake City (UT)

Hybrid

USD 32,000 - 48,000

Full time

14 days+

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Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401k with match

Paid Time Off

Paid Holidays

Tuition Reimbursement

Life insurance

Short-term disability

Long-term disability

Job summary

Onco360 Oncology Pharmacy is hiring a Pharmacy Adjudication Specialist in Mountain Time for a remote/hybrid role. The specialist adjudicates claims, reviews responses for accuracy, and resolves third-party denials to ensure timely medication delivery.

Requirements include Utah pharmacy technician credentials, 2+ years in pharmacy/claims, and knowledge of Medicare/Medicaid and COB. The role offers a starting wage of $23/hour with a $5,000 sign-on bonus for joining before Oct 31, 2026.

Qualifications

High School Diploma or GED required.
2+ years in Pharmacy/Healthcare or pharmacy claims experience.
Pharmacy/NDC billing and COB knowledge; Medicare/Medicaid knowledge.
NCPDP claim rejection resolution and pharmacy terminology knowledge.
Board of Pharmacy registration required; PTCB certification desirable.

Responsibilities

Adjudicate pharmacy claims for primary, secondary and tertiary plans; review claim responses for accuracy.
Resolve third-party rejections and obtain overrides when appropriate.
Communicate with providers and patients regarding active claims and delivery timelines.
Ensure patient setup in CPR+ with demographic and insurance details.
Assist with handling copays, refunds, and patient outreach before shipment.