Remote Pharmacy Claims Adjudication Specialist | $5k

Onco360; Denver (CO); Hybrid; USD 33,000 - 39,000; Full time

Benefits offered by this job

401k with match

Paid Time Off and Paid Holidays

Tuition Reimbursement

Company paid life and disability

Job summary

Onco360 is seeking a Pharmacy Claims Adjudication Specialist to adjudicate pharmacy claims and manage COB-related processes in a remote/hybrid Denver-based role. The position requires active Colorado Pharmacy Technician credentials and offers a starting wage of $24/hour with a $5,000 sign-on bonus for hires before December 31, 2026.

The role involves ensuring accurate adjudication, patient outreach, and coordination with insurers to minimize delays.

Qualifications

• Required: Pharmacy, Medical Billing, or Benefits Verification experience.
• Desired: Certified Pharmacy Technician (PTCB) or 2-year program degree.

Responsibilities

• Adjudicate pharmacy claims and review responses for accuracy.
• Resolve third-party rejections and obtain overrides when appropriate.
• Notify patients of delays due to insurance claim rejections.
• Ensure patient setup in CPR+ with proper demographics and insurance.
• Communicate with insurers to resolve gaps and resubmit claims.

Skills

Pharmacy billing

PBM contracts

Medicare/Medicaid knowledge

NCPDP resolution

Coordination of benefits

Pharmacy terminology

Math skills

Typing

Education

High School Diploma or GED

Associate degree or Certified Pharmacy Technician

Tools

CPR+ system

Job description

Onco360 is seeking a Pharmacy Claims Adjudication Specialist to adjudicate pharmacy claims and manage COB-related processes in a remote/hybrid Denver-based role. The position requires active Colorado Pharmacy Technician credentials and offers a starting wage of $24/hour with a $5,000 sign-on bonus for hires before December 31, 2026.

The role involves ensuring accurate adjudication, patient outreach, and coordination with insurers to minimize delays.