Remote Pharmacy Claims Adjudication Specialist (Oncology)

Onco360; St. Louis (MO); Hybrid; USD 52,000 - 62,000; Full time

Benefits offered by this job

401k with match

Paid Time Off and Holidays

Tuition Reimbursement

Company paid life and disability

Job summary

Onco360 is seeking a Pharmacy Claims Adjudication Specialist in the St. Louis area. The role involves adjudicating pharmacy claims, confirming claim accuracy, and resolving third-party rejections to ensure timely medication delivery.

Some remote work may be possible with Missouri Pharmacy Technician credentials. The position offers a sign-on bonus, benefits, and a starting hourly wage of $25.00+. Responsibilities include patient communications, copay management, and coordination with insurance

Qualifications

• Requires high school diploma or GED.
• Experience in Pharmacy, Medical Billing, or Benefits Verification preferred.
• Strong attention to detail and accuracy in claim adjudication.

Responsibilities

• Adjudicate pharmacy claims and review responses for accuracy.
• Resolve third-party rejections and obtain overrides when appropriate.
• Contact insurers to resolve rejections and notify patients about delays.
• Support patient outreach regarding copay and medication delivery timing.
• Maintain patient privacy and adhere to compliance rules.

Skills

First-call resolution

Customer service liaison

Pharmacy claims adjudication

Insurance claim research

CPR+ system

Education

High School Diploma or GED

Tools

CPR+

Job description

Onco360 is seeking a Pharmacy Claims Adjudication Specialist in the St. Louis area. The role involves adjudicating pharmacy claims, confirming claim accuracy, and resolving third-party rejections to ensure timely medication delivery.

Some remote work may be possible with Missouri Pharmacy Technician credentials. The position offers a sign-on bonus, benefits, and a starting hourly wage of $25.00+. Responsibilities include patient communications, copay management, and coordination with insurance