ZipRecruiter

Log In

1

Adjudicator Jobs in Texas (NOW HIRING)

Onco360

Supervisor - Pharmacy Adjudication

Houston, TX

$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

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 ...

Careington

Claims Finance Manager

Frisco, TX

Analyze claims payment activity, funding, payment activity, adjudication outcomes, and reimbursement trends to ensure financial accuracy and integrity * Monitor claim costs, payment variances ...

Texas Children's Hospital

Claims Examiner

Bellaire, TX · On-site

... adjudicated with a 98% procedural accuracy rate monthly as reviewed by weekly audit reports. • The claims should be adjudicated with a 98% accuracy rate monthly as reviewed by returned claims for ...

Texas Children's Hospital

Claims Examiner

Bellaire, TX · On-site

... adjudicated with a 98% procedural accuracy rate monthly as reviewed by weekly audit reports. • The claims should be adjudicated with a 98% accuracy rate monthly as reviewed by returned claims for ...

Optimum Life Reinsurance

Claims Assistant

Dallas, TX · On-site

$38K - $41K/yr

Set up claim files and prepare them for adjudication by the analysts. * Provide clerical support such as letter writing, copying, scanning, and mailing as needed. * Organize incoming documents in a ...

Optimum Informatique inc.

Claims Assistant

Dallas, TX · On-site

$18.75 - $23.50/hr

Set up claim files and prepare them for adjudication by the analysts * Provide clerical support such as letter writing, copying, scanning, and mailing as needed * Organize incoming documents in a ...

next page

Showing results 1-20

All JobsAdjudicator JobsAdjudicator Jobs in Texas

Adjudicator information

See Texas salary details

$29.8K

$57.7K

$86.6K

How much do adjudicator jobs pay per year?

As of Aug 27, 2026, the average yearly pay for adjudicator in Texas is $57,691.00, according to ZipRecruiter salary data. Most workers in this role earn between $45,200.00 and $66,100.00 per year, depending on experience, location, and employer.

What is an adjudicator?

Adjudicators are professionals responsible for making decisions or judgments on disputes, claims, or competitions. They review evidence, apply relevant laws or rules, and ensure a fair and impartial outcome. Adjudicators are commonly found in legal, insurance, government, and competitive event settings. Their work is essential for resolving conflicts and upholding standards of fairness and justice.

What does an adjudicator do?

An Adjudicator is a position that judges a formal dispute outside of a court, however, their decisions are still legally-binding. Adjudicators most often work on civil and non-violent cases. This process is less costly and less time-consuming compared to traditional court hearings. An Adjudicator is responsible for reviewing the facts of the case which may include pieces of hard evidence, personal statements, and the legal arguments of each side’s lawyers. Based on the relevant information, the Adjudicator makes a decision and a legally-acceptable judgment. Adjudicators are meant to be fair and unbiased, and there is no jury involved. Their decision is final, but involved parties are allowed to appeal those findings to a higher court.

What are the key skills and qualifications needed to thrive as an adjudicator, and why are they important?

To thrive as an Adjudicator, you need strong analytical skills, attention to detail, and a comprehensive understanding of relevant laws or regulations, often supported by a degree in law, public administration, or a related field. Familiarity with case management systems, legal research tools, and documentation software is typically required. Excellent written and verbal communication, impartiality, and sound judgment are crucial soft skills for effectively resolving disputes and rendering fair decisions. These abilities ensure accurate, unbiased adjudication, compliance with legal standards, and public trust in the decision-making process.

What are some common challenges faced by adjudicators, and how can they effectively manage them?

Adjudicators often encounter challenges such as managing a high caseload, handling complex or sensitive cases, and ensuring impartiality in decision-making. Staying organized and adhering to established procedures are crucial for balancing workload and maintaining consistency. Clear communication, continuous professional development, and effective time management can help adjudicators deliver fair and timely outcomes, even under pressure.

What is the difference between Adjudicator vs Arbitrator?

AspectAdjudicatorArbitrator
CredentialsLegal or industry-specific certifications, training in dispute resolutionLegal background or specialized training in arbitration
Work EnvironmentAdministrative hearings, government agencies, tribunalsPrivate arbitration settings, legal firms, corporate disputes
Industry UsageUsed in government, legal, and regulatory contextsCommon in legal, commercial, and international disputes

While both Adjudicators and Arbitrators resolve disputes, Adjudicators typically work within government or regulatory bodies and focus on administrative hearings, whereas Arbitrators are often hired privately to settle commercial or legal disputes outside court. Understanding these differences helps in choosing the right professional for specific dispute resolution needs.

What qualifications do I need to be an adjudicator?

To become an adjudicator, candidates typically need a relevant educational background such as a bachelor's degree, along with strong analytical, communication, and decision-making skills. Some roles may require specific certifications or experience in the field they oversee, and familiarity with relevant laws or regulations can be beneficial.
More about Adjudicator jobs

What are popular job titles related to Adjudicator jobs in Texas?

For Adjudicator jobs in Texas, the most frequently searched job titles are:

What job categories do people searching Adjudicator jobs in Texas look for?

The top searched job categories for Adjudicator jobs in Texas are:

What are popular job titles related to Adjudicator jobs in TX?

For Adjudicator jobs in TX, the most frequently searched job titles are:

Adjudicator jobs near you
Infographic showing various Adjudicator job openings in Texas as of August 2026, with employment types broken down into 83% Full Time, 10% Part Time, and 7% Contract. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution, with an average salary of $57,691 per year, or $27.7 per hour.

Pharmacy Claims Adjudication Specialist

Houston, TX • On-site

Onco360
Health Care and Social Assistance • 501 - 1,000 employees

7.7

Company rating: 7.7 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

20th of 113 rated pharmacies

Good employer

Paid breaks

Good training

Learn more about Onco360external

$21/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 29 days ago

Job description

We are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy in Houston, TX. This will be a Full-Time position. This position must be located within driving distance to our pharmacy, with a hybrid work style.
Shift times between 8am and 8pm.
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 $21.00 an hour and up
Sign-On Bonus: $5,000 for employees starting before September 30th, 2026.
We offer a variety of benefits including:
  • Medical; Dental; Vision
  • 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 Major Responsibilities:
The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections
Pharmacy Adjudication Specialists at Onco360...
  • Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests.
  • Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding active claims information.
  • Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information.
  • 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
  • Ensures copay cards are only applied to claims for eligible patients based on set criteria such as insurance type (Government beneficiaries not eligible)
  • Manages all funding related adjudications and works as a liaison to Onco360 Advocate team.
  • Assists pharmacy team with all management of electronically adjudicated claims to ensure all prescription delivery assessments are reconciled and copay payments are charged prior to shipment.
  • Serves as customer service liaison to patients regarding financial responsibility prior to shipments, contacts patients to communicate any copay discrepancy between quoted amount and claim and collects payment if applicable.
  • Documents and submit requests for Patient Refunds when appropriate.
  • Maintain 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.

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 or pharmacy claims experience
    • Desired: 3+ years experience in Pharmacy/Healthcare Setting or pharmacy 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)
  • 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

#IH

What Onco360 employees say

Pay

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply