ZipRecruiter

Log In

2

Full Time Pharmacy Claims Auditor Jobs in Buffalo, NY

Woodmark

Pharmacy Billing Specialist

Buffalo, NY · On-site

$18/hr

This position is Full Time on-site! Benefits of working at Woodmark of NY: * Full Benefits Package ... Electronic billing of Medicare, Medicaid and Third Party Insurance pharmacy claims utilizing ...

Wegmans Food Markets

Pharmacy Technician

Depew, NY · On-site

$19 - $19.50/hr

Must be 18 years or older Time Type: Full time Pay Range: $19 - $19.50 / hour Why Work Here Working ... Troubleshoot the rejected insurance claims and address issues to support customers' needs

Wegmans Food Markets

Pharmacy Technician

Amherst, NY · On-site

$19 - $19.50/hr

Must be 18 years or older Time Type: Full time Pay Range: $19 - $19.50 / hour Why Work Here Working ... Troubleshoot the rejected insurance claims and address issues to support customers' needs

Wegmans Food Markets

Pharmacy Technician

Buffalo, NY · On-site

$19 - $20/hr

Must be 18 years or older Time Type: Full time Pay Range: $19 - $20 / hour Why Work Here Working at ... Troubleshoot the rejected insurance claims and address issues to support customers' needs

Walgreens

Pharmacy Operations Manager

Buffalo, NY · On-site

Serves as a full-time certified pharmacy technician. * Responsible for operating pharmacy systems ... Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment ...

Walgreens

Pharmacy Operations Manager

Buffalo, NY · On-site

Serves as a full-time certified pharmacy technician. * Responsible for operating pharmacy systems ... Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment ...

Wegmans

Pharmacy Technician

Amherst, NY

$19 - $19.50/hr

Schedule: Full time Availability: Morning, Afternoon, Evening (Includes Weekends). Age Requirement ... Troubleshoot the rejected insurance claims and address issues to support customers' needs

Wegmans

Pharmacy Technician

Depew, NY · On-site

$19 - $19.50/hr

Schedule: Full time Availability: Morning, Afternoon, Evening (Includes Weekends). Age Requirement ... Troubleshoot the rejected insurance claims and address issues to support customers' needs

Wegmans

Pharmacy Technician

Blasdell, NY · On-site

$19 - $20/hr

Schedule: Full time Availability: Morning, Afternoon, Evening (Includes Weekends). Age Requirement ... Troubleshoot the rejected insurance claims and address issues to support customers' needs

next page

Showing results 1-20

People also search for

All JobsFull Time Pharmacy Claims Auditor JobsFull Time Pharmacy Claims Auditor Jobs in Buffalo, NY

Full Time Pharmacy Claims Auditor information

See Buffalo, NY salary details

$13

$25

$46

How much do full time pharmacy claims auditor jobs pay per hour?

As of May 28, 2026, the average hourly pay for full time pharmacy claims auditor in Buffalo, NY is $25.99, according to ZipRecruiter salary data. Most workers in this role earn between $19.09 and $28.89 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Full Time Pharmacy Claims Auditor, and why are they important?

To thrive as a Full Time Pharmacy Claims Auditor, you need a strong understanding of pharmacy operations, claims processing, and healthcare regulations, typically backed by a degree in pharmacy, healthcare, or a related field. Familiarity with pharmacy benefit management (PBM) systems, claims auditing software, and data analysis tools is essential, and certifications such as CPhT or CPC can be advantageous. Attention to detail, analytical thinking, and strong communication skills help auditors identify discrepancies and convey findings effectively. These competencies are crucial for ensuring compliance, reducing errors, and protecting financial integrity in pharmacy claims processing.

What are some common challenges faced by Full Time Pharmacy Claims Auditors, and how can they be overcome?

Full Time Pharmacy Claims Auditors often encounter challenges such as staying up-to-date with evolving insurance policies, identifying fraudulent claims, and managing large volumes of complex data. To overcome these obstacles, auditors regularly participate in ongoing training, utilize advanced auditing software, and collaborate closely with pharmacists, insurance providers, and compliance teams. Developing strong attention to detail and effective communication skills is essential for success and accuracy in this role.

What are Full Time Pharmacy Claims Auditors?

Full Time Pharmacy Claims Auditors are professionals who review and analyze pharmacy claims to ensure accuracy, compliance with regulations, and detect any potential fraud or billing errors. They typically work for insurance companies, pharmacy benefit managers, or healthcare organizations. Their responsibilities include verifying claim data, ensuring prescriptions are billed correctly, and collaborating with pharmacies to resolve discrepancies. By auditing claims, they help maintain the integrity of pharmacy billing processes and control costs for healthcare payers.

What is the difference between Full Time Pharmacy Claims Auditor vs Part Time Pharmacy Claims Auditor?

AspectFull Time Pharmacy Claims AuditorPart Time Pharmacy Claims Auditor
CredentialsTypically requires pharmacy technician certification or relevant healthcare experienceSame as full-time, often with flexible or part-time certifications
Work EnvironmentFull-time, office-based or remote healthcare settingPart-time, similar environment but with fewer hours
Industry UsageCommon in healthcare insurance companies, pharmacy benefit managersUsed in similar settings, often for supplemental staffing
Search & Comparison IntentHigh, as employers and job seekers compare roles for career planning

The main difference between a Full Time Pharmacy Claims Auditor and a Part Time Pharmacy Claims Auditor lies in the hours worked and availability. Both roles require similar credentials and are found in healthcare insurance and pharmacy benefit management industries. Full-time auditors work standard hours, providing consistent coverage, while part-time auditors offer flexible scheduling. Both positions serve similar functions in auditing pharmacy claims to ensure accuracy and compliance.

What are popular job titles related to Full Time Pharmacy Claims Auditor jobs in Buffalo, NY? For Full Time Pharmacy Claims Auditor jobs in Buffalo, NY, the most frequently searched job titles are:
What job categories do people searching Full Time Pharmacy Claims Auditor jobs in Buffalo, NY look for? The top searched job categories for Full Time Pharmacy Claims Auditor jobs in Buffalo, NY are:
What cities near Buffalo, NY are hiring for Full Time Pharmacy Claims Auditor jobs? Cities near Buffalo, NY with the most Full Time Pharmacy Claims Auditor job openings:
Full Time Pharmacy Claims Auditor jobs near you
Infographic showing various Full Time Pharmacy Claims Auditor job openings in Buffalo, NY as of May 2026, with employment types broken down into 93% Full Time, 6% Part Time, and 1% Temporary. Highlights an 93% Physical, and 7% Remote job distribution, with an average salary of $54,057 per year, or $26 per hour.
Pharmacy Claims Adjudication Specialist

Pharmacy Claims Adjudication Specialist

Onco360

Buffalo, NY • On-site

$23/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 24 days ago

Job description

We are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy in Buffalo, NY. 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 currently available: 8:30am-5:00 pm EST, 10:30 am-7:00 pm EST, or 11:30am-8:00 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.
Starting salary from $23.00 an hour and up
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.
  • Document and submit requests for Patient Refunds when appropriate.
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: 1+ 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

Apply