Position: Pharmacy Claims Adjudication Specialist
Location: Albuquerque, NM
Job Id: 5446
# of Openings: 1
We are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy working in Mountain Time Zone.This will be a Full-Time position. This is a remote/hybrid opportunity,
Full-Time position may work remotely but MUST HAVE ACTIVE NEW MEXICO PHARMACY TECHNICIAN credentials from the State Board of Pharmacy.
Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers.
Starting salary from $22.00 an hour and up
Sign-On Bonus: $5,000 for employees starting before August 31, 2026.
We offer a variety of benefits including:
- 401k with a match
- Paid Time Off and Paid Holidays
- Tuition Reimbursement
- Company paid benefits – life; and short and long-term disability
Pharmacy Adjudication Specialist Qualifications and Responsibilities...
- Education/Learning Experience
- Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification, Pharmacy Claims Adjudication
- Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician, Specialty pharmacy experience
- Work Experience
- Required: 2+ years experience in Pharmacy/Healthcare Setting orpharmacy claims experience
- Desired: 3+ yearsexperience in Pharmacy/Healthcare Setting orpharmacy claims experience
- Skills/Knowledge
- Required:Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills
- Desired: Knowledge of Foundation Funding, Specialty pharmacy experience
- Licenses/Certifications
- Required:Registration with Board of Pharmacy as required by state law
- Desired:Certified Pharmacy Technician (PTCB)
- Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skills