Remote Pharmacy Claims Adjudication Specialist

Onco360 Oncology Pharmacy; Scottsdale (AZ); Hybrid; USD 26,000 - 37,000; Full time

Benefits offered by this job

Medical

Dental

Vision

401k match

Paid Time Off

Paid Holidays

Tuition Reimbursement

Company paid benefits – life

Short/long-term disability

Job summary

Onco360 Oncology Pharmacy in Scottsdale, AZ is seeking a Pharmacy Adjudication Specialist for a full-time, hybrid role with initial onsite training. The position offers a starting wage of $23.00 per hour plus a $5,000 sign-on bonus for those starting before December 31, 2026.

Benefits include medical, dental, vision, 401k match, PTO, holidays, tuition reimbursement, and comprehensive company-paid coverage. The specialist will adjudicate claims, ensure COB accuracy, engage with insurers, manage

Qualifications

• Requires High School Diploma or GED; pharmacy/medical billing experience preferred.
• Associate degree or equivalent program in two-year program is desirable; PTCB certification is a plus.

Responsibilities

• Adjudicate pharmacy claims for active workflows across primary, secondary and tertiary plans.
• Review claim responses for accuracy and correct COB coordination.
• Resolve third-party rejections and obtain overrides when appropriate.
• Notify patients about delays due to insurance rejections and reschedule medications.
• Ensure accurate patient enrollment in CPR+ with correct demographics and insurance data.
• Communicate with insurance companies to resolve rejections and ensure timely shipping.

Skills

Pharmacy claims

NCPDP rejection

Coordination of benefits

Medicare/Medicaid knowledge

PBM contracts

Basic math

Typing

Pharmacy terminology

Education

High School Diploma or GED

Associate degree (preferred)

Tools

CPR+ system

Job description

Onco360 Oncology Pharmacy in Scottsdale, AZ is seeking a Pharmacy Adjudication Specialist for a full-time, hybrid role with initial onsite training. The position offers a starting wage of $23.00 per hour plus a $5,000 sign-on bonus for those starting before December 31, 2026.

Benefits include medical, dental, vision, 401k match, PTO, holidays, tuition reimbursement, and comprehensive company-paid coverage. The specialist will adjudicate claims, ensure COB accuracy, engage with insurers, manage