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Adjudication Jobs (NOW HIRING)

Onco360

Supervisor - Pharmacy Adjudication

Buffalo, NY · On-site

$63 - $74/hr

Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...

Onco360

Supervisor - Pharmacy Adjudication

Houston, TX · On-site

$62 - $73/hr

Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...

Onco360

Supervisor - Pharmacy Adjudication

Buffalo, NY · On-site

$63 - $74.25/hr

Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...

Onco360

Supervisor - Pharmacy Adjudication

Waltham, MA · On-site

$70 - $82.50/hr

Adjudication Supervisor Essential Functions: * Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee ...

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Adjudication information

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$15

$36

$46

How much do adjudication jobs pay per hour?

As of Jul 15, 2026, the average hourly pay for adjudication in the United States is $36.99, according to ZipRecruiter salary data. Most workers in this role earn between $31.49 and $42.79 per hour, depending on experience, location, and employer.

What is an Adjudication job?

An adjudication job involves reviewing and analyzing claims, applications, or cases to determine eligibility, compliance, or resolution based on established guidelines and policies. Adjudicators work in various fields such as insurance, legal disputes, government benefits, and background checks. Their role includes reviewing documents, verifying information, and making impartial decisions to ensure fair outcomes. Strong attention to detail, analytical skills, and knowledge of relevant regulations are essential for this role.

What are some common responsibilities in an Adjudication role?

Professionals working in Adjudication are responsible for reviewing claims, appeals, or disputes to determine their eligibility or validity based on established guidelines and regulations. Daily tasks often include gathering and analyzing evidence, preparing detailed reports, and communicating decisions to involved parties while ensuring compliance with all applicable laws and policies. Adjudicators also collaborate frequently with internal teams such as customer service, legal, and compliance departments to ensure thorough and accurate decision-making. This role often involves managing multiple cases simultaneously, making strong organizational and time-management skills essential for success.

What are the key skills and qualifications needed to thrive in the Adjudication position, and why are they important?

To excel in an Adjudication role, candidates typically need strong analytical abilities, attention to detail, and a background in legal, insurance, or compliance fields, often supported by a relevant degree or professional certification. Familiarity with case management systems, claims processing software, and regulatory databases is commonly required. Excellent problem-solving, communication, and impartial decision-making skills help professionals stand out in this position. These attributes are critical for ensuring fair, consistent, and efficient resolutions in complex claims or disputes.

More about Adjudication jobs
What cities are hiring for Adjudication jobs? Cities with the most Adjudication job openings:
What are the most commonly searched types of Adjudication jobs? The most popular types of Adjudication jobs are:
What states have the most Adjudication jobs? States with the most job openings for Adjudication jobs include:
What job categories do people searching Adjudication jobs look for? The top searched job categories for Adjudication jobs are:
Adjudication jobs near you
Infographic showing various Adjudication job openings in the United States as of July 2026, with employment types broken down into 86% Full Time, 12% Part Time, 1% Temporary, and 1% Contract. Highlights an 77% Physical, 4% Hybrid, and 19% Remote job distribution, with an average salary of $76,935 per year, or $37 per hour.
Supervisor - Pharmacy Adjudication

Supervisor - Pharmacy Adjudication

Onco360

Buffalo, NY • On-site

$63 - $74/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 23 days ago

Job description

Onco360 Pharmacy has a need for qualified candidates to fill our role of Pharmacy Adjudication Supervisor. This is an excellent opportunity to join our company and help with our expanding Specialty Pharmacy program! This is a full-time position, Monday to Friday 9:30 am to 6:00 pm EST.
Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers.
A career with us is more than just a job. It's an opportunity to connect and care for our patients, providers, communities and each other. We attract extraordinary people who have a strong desire to live our mission - to better the lives of those battling cancer and rare diseases. Compassion is more important than numbers. We value teamwork, respect, integrity, and passion.
We succeed when you do, and our company and management team work hard to foster an environment that provides you with opportunities for both professional and personal growth.
Salary range starting at $46k and up depending on experience
Sign-On Bonus: $5,000 for employees starting before July 31, 2026.
We offer a variety of benefits including:
  • Medical; Dental; Vision
  • 401k with a match
  • Paid Time Off and Paid Holidays
  • Quarterly Incentive Bonuses
  • Tuition Reimbursement
  • Company paid benefits - life insurance; and short and long-term disability

The Pharmacy Adjudication Supervisor is responsible for all aspects of pharmacy claims adjudication, accuracy of pharmacy claims, resolution of third-party rejections, coordination of benefits, and patient outreach regarding any delay in medication delivery due to insurance claim rejections. This role requires advanced program knowledge and will provide quality control by routinely examining cases completed by team members.
Adjudication Supervisor Essential Functions:
  • Supervises adjudication staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee relations issues and reduce turnover. Communicates effectively across pharmacy and/or corporate teams and with patients, and successfully resolves issues.
  • Assists Director of Pharmacy Operations in day-to-day pharmacy operations and in implementing new procedures to ensure that the accurate and timely dispensing of quality pharmacy services is consistently delivered to all patients using effective service leadership and customer skills.
  • Works with pharmacy management to recruit, select, hire, orientate, develop, and train new associates. On an ongoing basis, evaluates, coaches, and utilizes performance management practices to motivate and set expectations for PA staff. In collaboration with management, drafts and delivers effective corrective action plans and disciplinary action to technicians performing at substandard levels.
  • Manages and reports on daily activity of vertical team members, including monitoring of daily workflow and Pulse reporting.
  • Handles escalations for difficult claim rejection resolution cases/questions to ensure accurate and timely completion of adjudication.
  • Adjudicates pharmacy claims for prescriptions in active workflow for primary, secondary, and tertiary pharmacy plans and reviews claim responses for accuracy before accepting the claim.
  • Contacts insurance companies to resolve third-party rejections and ensures pharmacy claim rejections are resolved to allow for timely shipping of medications. Performs outreach calls to patients or providers to reschedule their medication deliveries if claim resolution cannot be completed by ship date and causes shipment delays.
  • Contacts insurance companies to follow up on prior authorization requests, including determining if any additional information is needed, or whether the claim is in review, approved, or denied. Document all prior authorization information in patient profile.
  • Works with Pharmacy Technician Manager and/or Director of Pharmacy Operations on other responsibilities, projects, implementations, and initiatives as needed.
  • Maintains a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws.
  • Contributes to team effort by accomplishing related tasks as needed and other duties as assigned.
  • Conducts job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.

Adjudication SupervisorQualifications:
Education/Learning Experience
  • Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification, Knowledge of insurance and applicable regulations
  • Desired: Associates or Bachelor's Degree, Certified Pharmacy Technician, Specialty pharmacy experience

Work Experience
  • Required: 4+ years pharmacy or pharmacy adjudication or equivalent experience, previous leadership experience
  • Desired: 5+ years pharmacy or pharmacy adjudication or equivalent experience, 1+ years supervisor experience, Specialty pharmacy experience

Skills/Knowledge
  • Required: NDC medication billing, PBM and medical contracts, healthcare audit experience, knowledge of Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, excellent interpersonal skills, able to work with all levels of management and staff, vast knowledge of pharmacy terminology and process including sig codes, and roman numerals, brand/generic names of medication, advanced typing, math and analytical skills.
  • Desired: Specialty pharmacy operations, leadership skills, independent decision-making abilities, able to conduct research, be resourceful, and self-reliant, excellent communication skills

Licenses/Certifications
  • Required: Registration with Board of Pharmacy as required by state law
  • Desired: Certified Pharmacy Technician (PTCB), Advanced Certified Pharmacy Technician with completion of Billing and Reimbursement certification

Behavior Competencies
  • 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, leadership

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