Remote Pharmacy Claims Adjudication Specialist (Indiana Tech)

Onco360 Oncology Pharmacy; Indianapolis (IN); Remote; USD 28,000 - 40,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401k with match

Paid time off

Paid holidays

Tuition reimbursement

Life insurance

Short-term disability

Long-term disability

Job summary

Onco360 Oncology Pharmacy in the United States is seeking a Pharmacy Adjudication Specialist for our specialty oncology operations. This full-time role may work remotely but requires active Indiana Pharmacy Technician credentials.

Starting salary is $25.00 per hour with a $5,000 sign-on bonus for hires starting before December 31, 2026. Benefits include medical/dental/vision, 401k, PTO, tuition reimbursement, and disability coverage.

Qualifications

• 2+ years experience in Pharmacy/Healthcare or pharmacy claims.
• High School Diploma or GED required.
• Pharmacy Technician license/registration as required by state law.
• Desired: Associate degree or equivalent and Specialty pharmacy experience.

Responsibilities

• First call resolution to help providers and patients with pharmacy needs.
• Provide accurate responses to requests regarding active claims.
• Ensure patientSetup in CPR+ with demographics and insurance info.
• Adjudicate claims for primary/secondary/tertiary plans; verify accuracy.
• Contact insurers to resolve third-party rejections and avoid shipment delays.
• Apply copay cards only for eligible patients; no Government beneficiaries eligibility.
• Coordinate funding adjudications and liaise with Onco360 Advocate team.
• Assist with adjudicated claims; ensure delivery assessments and copay payments before shipment.
• Serve as customer service liaison regarding financial responsibility prior to shipments.
• Document and submit requests for Patient Refunds when appropriate.
• Maintain a safe, clean pharmacy and comply with laws and confidentiality.
• Contribute to team effort and perform other duties as assigned.

Skills

Pharmacy billing

NDC medication billing

Claims resolution

Medicare knowledge

Medicaid knowledge

PBM contracts

Insurance knowledge

NCPDP rejection resolution

Coordination of benefits

Pharmacy terminology

Sig codes

Roman numerals

Brand vs generic names

Math skills

Typing skills

Education

High School Diploma or GED

Associate degree or equivalent program

Certified Pharmacy Technician

Tools

CPR+ system

Job description

Onco360 Oncology Pharmacy in the United States is seeking a Pharmacy Adjudication Specialist for our specialty oncology operations. This full-time role may work remotely but requires active Indiana Pharmacy Technician credentials.

Starting salary is $25.00 per hour with a $5,000 sign-on bonus for hires starting before December 31, 2026. Benefits include medical/dental/vision, 401k, PTO, tuition reimbursement, and disability coverage.