Remote Pharmacy Claims Adjudication Tech

Onco360 Oncology Pharmacy; Denver (CO); Hybrid; USD 28,000 - 39,000; Full time

Benefits offered by this job

Medical/Dental/Vision

401k match

PTO & Holidays

Tuition Reimbursement

Life Insurance/Disability

Job summary

Onco360 Oncology Pharmacy is seeking a Pharmacy Adjudication Specialist for a full-time role in a remote/hybrid setup within the Mountain Time Zone. Candidates must hold active Colorado Pharmacy Technician credentials.

Starting wage is $24.00 per hour with a $5,000 sign-on bonus for hires before Oct 31, 2026. The role focuses on adjudicating pharmacy claims, resolving third-party rejections, coordinating benefits, and ensuring timely shipments while communicating copays and delivery timelines to

Qualifications

• High School Diploma or GED required; experience in Pharmacy, Medical Billing, or Benefits Verification preferred.
• Associate degree or technical program and/or Certified Pharmacy Technician preferred.
• 2+ years of experience in Pharmacy/Healthcare or pharmacy claims required; 3+ preferred.

Responsibilities

• Adjudicate pharmacy claims and review responses for accuracy.
• Resolve third-party rejections and obtain overrides when appropriate.
• Notify patients about delays in medication delivery due to insurance claims.
• Ensure complete patient setup in CPR+ with demographics and insurance.
• Contact insurers to resolve rejections and reschedule deliveries if needed.
• Communicate copay details and collect payments when applicable.

Skills

Pharmacy claims resolution

NCPDP claim rejection resolution

Coordination of benefits

Medicare/Medicaid knowledge

Pharmacy terminology (sig codes, Roman

Basic math and analytical skills

Interpersonal and communication skills

Typing

Education

High School Diploma or GED

Associate degree or Certified Pharmacy Technician

Tools

CPR+ system

Job description

Onco360 Oncology Pharmacy is seeking a Pharmacy Adjudication Specialist for a full-time role in a remote/hybrid setup within the Mountain Time Zone. Candidates must hold active Colorado Pharmacy Technician credentials.

Starting wage is $24.00 per hour with a $5,000 sign-on bonus for hires before Oct 31, 2026. The role focuses on adjudicating pharmacy claims, resolving third-party rejections, coordinating benefits, and ensuring timely shipments while communicating copays and delivery timelines to