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Claims Adjudication Jobs (NOW HIRING)

Onco360

Pharmacy Claims Adjudication Specialist

Hartford, CT · Remote

$26/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of ...

Onco360

Pharmacy Claims Adjudication Specialist

Columbus, OH · Remote

$23/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of ...

Onco360

Pharmacy Claims Adjudication Specialist

Burlington, VT · Remote

$25/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of ...

Onco360

Pharmacy Claims Adjudication Specialist

Pittsburgh, PA · Remote

$23/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of ...

Onco360

Pharmacy Claims Adjudication Specialist

Hartford, CT · On-site

$26/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of ...

Onco360

Pharmacy Claims Adjudication Specialist

Denver, CO · On-site

$24/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of ...

Onco360

Pharmacy Claims Adjudication Specialist

Saint Louis, MO · Remote

$25/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of ...

Onco360

Pharmacy Claims Adjudication Specialist

Indianapolis, IN · Remote

$25/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of ...

Onco360

Pharmacy Claims Adjudication Specialist

Albuquerque, NM · Remote

$22/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of ...

Onco360

Pharmacy Claims Adjudication Specialist

Albuquerque, NM · On-site

$22/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of ...

Onco360

Pharmacy Claims Adjudication Specialist

Denver, CO · Remote

$24/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of ...

Onco360

Pharmacy Claims Adjudication Specialist

Waltham, MA · On-site

$26/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of ...

Onco360

Pharmacy Claims Adjudication Specialist

Saint Louis, MO · On-site

$25/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of ...

Onco360

Pharmacy Claims Adjudication Specialist

Indianapolis, IN · On-site

$25/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of ...

Onco360

Pharmacy Claims Adjudication Specialist

Buffalo, NY · On-site

$23/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of ...

Onco360

Pharmacy Claims Adjudication Specialist

Houston, TX · On-site

$21/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of ...

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Showing results 21-40

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Claims Adjudication information

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How much do claims adjudication jobs pay per hour?

As of Aug 14, 2026, the average hourly pay for claims adjudication in the United States is $29.40, according to ZipRecruiter salary data. Most workers in this role earn between $22.36 and $35.10 per hour, depending on experience, location, and employer.

What are the typical daily responsibilities of someone working in claims adjudication?

As a Claims Adjudication professional, your daily responsibilities generally include receiving and reviewing insurance claims, verifying information and supporting documentation, applying policy guidelines, and determining coverage eligibility or payment amounts. You may also be required to correspond with policyholders, medical providers, or other parties to gather additional information or clarify details. Regular collaboration with team members, supervisors, and other departments helps ensure consistency and accuracy in decision-making. Staying organized and managing multiple cases at various stages is essential for meeting deadlines and maintaining workflow efficiency.

What are the key skills and qualifications needed to thrive in claims adjudication?

To thrive in Claims Adjudication, a strong understanding of insurance policies, medical or legal terminology, and analytical skills is usually required, often supported by a degree in a relevant field or equivalent experience. Familiarity with claims management systems, databases, and software such as Microsoft Office or specialized adjudication platforms is essential. Attention to detail, problem-solving ability, and effective communication skills help professionals excel when reviewing claims and interacting with clients or team members. These competencies are critical to ensure accurate claim processing, compliance with regulations, and a high standard of customer service.

What is claims adjudication?

A Claims Adjudication job involves reviewing and processing insurance claims to determine their validity and accuracy. Professionals in this role assess medical, health, or other types of claims based on policy terms, provider agreements, and regulatory guidelines. They verify documentation, check for errors, and decide whether to approve, deny, or request further information. Claims adjudicators ensure that payments are correctly calculated and comply with company policies. This role requires attention to detail, knowledge of industry regulations, and strong analytical skills.

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What are the most commonly searched types of Claims Adjudication jobs?

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Claims Adjudication jobs near you
Infographic showing various Claims Adjudication job openings in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $61,156 per year, or $29.4 per hour.

Pharmacy Claims Adjudication Specialist

Onco360

Hartford, CT • Remote

$26/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 26 days ago

Onco360 rating

7.7

Company rating: 7.7 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

20th of 112 rated pharmacies

Job description

We are seeking a Pharmacy Adjudication Specialist for our Specialty Oncology pharmacy.
As our company continues to grow, we strive to hire new team members with a passion for making a difference in our patient's lives.
Full-Time position may work remotely but MUST HAVE ACTIVE CONNECTICUT PHARMACY TECHNICIAN credentials from the State Board of Pharmacy.
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 $26.00 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.
  • Documenst 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
    • Desired: Registration with Board of Pharmacy as required by state law; 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

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