Remote Pharmacy Claims Adjudication Specialist (PA Tech)

Onco360 Oncology Pharmacy; Pittsburgh (Allegheny County); Remote; USD 26,000 - 37,000; Full time

Benefits offered by this job

Medical

Dental

Vision

401k with match

Paid Time Off

Paid Holidays

Tuition Reimbursement

Life insurance

Short & long-term disability

Job summary

Onco360 Oncology Pharmacy is seeking a Pharmacy Adjudication Specialist to adjudicate pharmacy claims and manage insurance coordination for timely medication delivery. The role supports patients and providers, ensuring accurate claim adjudication and patient billing communications.

The position offers full-time hours and a remote-work option for candidates with active Pennsylvania Pharmacy Technician credentials.

Qualifications

• High School Diploma or GED required; pharmacy/medical billing or benefits verification experience preferred.
• Associate degree or Tech program and Certified Pharmacy Technician a plus; specialty pharmacy experience desirable.

Responsibilities

• Adjudicate pharmacy claims and review responses for accuracy.
• Resolve third-party rejections and obtain overrides when appropriate.
• Notify patients regarding delays due to insurance issues.
• Maintain accurate patient setup and insurance data in CPR+ system.
• Coordinate with insurance to ensure timely shipment and copay accuracy.
• Provide customer service liaison regarding financial responsibility prior to shipments.

Skills

Pharmacy claims resolution

Coordination of benefits

Medicare/Medicaid knowledge

NCPDP claim rejection resolution

Brand/generic names

Basic math & analytical skills

CPR+ system

Phone/email patient outreach

Education

High School Diploma or GED

Associate degree or equivalent program

Certified Pharmacy Technician

Specialty pharmacy experience

Tools

CPR+

Job description

Onco360 Oncology Pharmacy is seeking a Pharmacy Adjudication Specialist to adjudicate pharmacy claims and manage insurance coordination for timely medication delivery. The role supports patients and providers, ensuring accurate claim adjudication and patient billing communications.

The position offers full-time hours and a remote-work option for candidates with active Pennsylvania Pharmacy Technician credentials.