PBM Billing Specialist Senior
$19.22 - $34.90/hr
PBM Billing Specialist Senior PBM Billing Specialist Senior Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ...
$19.22 - $34.90/hr
PBM Billing Specialist Senior PBM Billing Specialist Senior Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ...
$19.22 - $34.90/hr
PBM Billing Specialist Senior PBM Billing Specialist Senior Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ...
$19.22 - $34.90/hr
PBM Billing Specialist Senior PBM Billing Specialist Senior Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ...
$19.22 - $34.90/hr
PBM Billing Specialist Senior PBM Billing Specialist Senior Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ...
$19.22 - $34.90/hr
PBM Billing Specialist Senior PBM Billing Specialist Senior Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ...
$19.22 - $34.90/hr
PBM Billing Specialist Senior PBM Billing Specialist Senior Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ...
$19.22 - $34.90/hr
PBM Billing Specialist Senior PBM Billing Specialist Senior Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ...
$19.22 - $34.90/hr
PBM Billing Specialist Senior PBM Billing Specialist Senior Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ...
$19.22 - $34.90/hr
PBM Billing Specialist Senior Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.
$19.22 - $34.90/hr
PBM Billing Specialist Senior Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.
$19.22 - $34.90/hr
PBM Billing Specialist Senior Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.
$19.22 - $34.90/hr
PBM Billing Specialist Senior Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.
$19.22 - $34.90/hr
PBM Billing Specialist Senior Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.
$19.22 - $34.90/hr
PBM Billing Specialist Senior Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.
$19.22 - $34.90/hr
PBM Billing Specialist Senior Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.
$19.22 - $34.90/hr
PBM Billing Specialist Senior Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.
$74K - $135K/yr
PBM Financial Analyst Lead PBM Financial Analyst Lead This role requires associates to be in-office1 - 2days per week, fostering collaboration and connectivity, while providing flexibility to support ...
$74K - $135K/yr
PBM Financial Analyst Lead PBM Financial Analyst Lead This role requires associates to be in-office1 - 2days per week, fostering collaboration and connectivity, while providing flexibility to support ...
$74K - $135K/yr
PBM Financial Analyst Lead PBM Financial Analyst Lead This role requires associates to be in-office1 - 2days per week, fostering collaboration and connectivity, while providing flexibility to support ...
$74K - $135K/yr
PBM Financial Analyst Lead PBM Financial Analyst Lead This role requires associates to be in-office1 - 2days per week, fostering collaboration and connectivity, while providing flexibility to support ...
$74K - $135K/yr
PBM Financial Analyst Lead PBM Financial Analyst Lead This role requires associates to be in-office1 - 2days per week, fostering collaboration and connectivity, while providing flexibility to support ...
$74K - $135K/yr
PBM Financial Analyst Lead PBM Financial Analyst Lead This role requires associates to be in-office1 - 2days per week, fostering collaboration and connectivity, while providing flexibility to support ...
$74K - $135K/yr
PBM Financial Analyst Lead PBM Financial Analyst Lead This role requires associates to be in-office1 - 2days per week, fostering collaboration and connectivity, while providing flexibility to support ...
$74K - $135K/yr
PBM Financial Analyst Lead PBM Financial Analyst Lead This role requires associates to be in-office1 - 2days per week, fostering collaboration and connectivity, while providing flexibility to support ...
$74K - $135K/yr
PBM Financial Analyst Lead This role requires associates to be in-office1 - 2days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life ...
$74K - $135K/yr
PBM Financial Analyst Lead This role requires associates to be in-office1 - 2days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life ...
$74K - $135K/yr
PBM Financial Analyst Lead This role requires associates to be in-office1 - 2days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life ...
$74K - $135K/yr
PBM Financial Analyst Lead This role requires associates to be in-office1 - 2days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life ...
$74K - $135K/yr
PBM Financial Analyst Lead This role requires associates to be in-office1 - 2days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life ...
$74K - $135K/yr
PBM Financial Analyst Lead This role requires associates to be in-office1 - 2days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life ...
$74K - $135K/yr
PBM Financial Analyst Lead This role requires associates to be in-office1 - 2days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life ...
$74K - $135K/yr
PBM Financial Analyst Lead This role requires associates to be in-office1 - 2days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life ...
Dulles, VA · On-site
Qualifications Required: - Strong SYNON/COOL 2E coding skills - Experience with RxCLAIM or Healthcare PBM application - Experience with Benefit Plan and Core Adjudication in RxCLAIM - 5 - 8 Years of ...
Quick apply
Dulles, VA · On-site
Qualifications Required: - Strong SYNON/COOL 2E coding skills - Experience with RxCLAIM or Healthcare PBM application - Experience with Benefit Plan and Core Adjudication in RxCLAIM - 5 - 8 Years of ...
$90K - $120K/yr
Strong knowledge of PBM concepts * Enthusiasm for building talent pipelines for the liberty movement What We Offer * Competitive benefits: Enjoy a 6% 401(k) match with immediate vesting, flexible ...
$90K - $120K/yr
Strong knowledge of PBM concepts * Enthusiasm for building talent pipelines for the liberty movement What We Offer * Competitive benefits: Enjoy a 6% 401(k) match with immediate vesting, flexible ...
Automate and streamline reporting to increase efficiency and reduce manual processes within PBM pricing operations. * Contribute to Specialty Pricing operations by: * Managing pricing appeals ...
Automate and streamline reporting to increase efficiency and reduce manual processes within PBM pricing operations. * Contribute to Specialty Pricing operations by: * Managing pricing appeals ...
Automate and streamline reporting to increase efficiency and reduce manual processes within PBM pricing operations. * Contribute to Specialty Pricing operations by: * Managing pricing appeals ...
Automate and streamline reporting to increase efficiency and reduce manual processes within PBM pricing operations. * Contribute to Specialty Pricing operations by: * Managing pricing appeals ...
$20.8K - $27.4K
2% of jobs
$27.4K - $33.9K
6% of jobs
$33.9K - $40.4K
16% of jobs
$40.8K is the 25th percentile. Wages below this are outliers.
$40.4K - $47K
17% of jobs
The median wage is $49.6K / yr.
$47K - $53.5K
23% of jobs
$58.3K is the 75th percentile. Wages above this are outliers.
$53.5K - $60K
16% of jobs
$60K - $66.6K
8% of jobs
$66.6K - $73.1K
6% of jobs
$73.1K - $79.6K
3% of jobs
$79.6K - $86.2K
1% of jobs
$86.2K - $92.7K
2% of jobs
$20.8K
$53K
$92.7K
Pharmacy Benefit Managers often encounter challenges such as staying compliant with frequently changing healthcare regulations, managing relationships between pharmacies, insurers, and clients, and controlling rising prescription drug costs. To address these challenges, PBMs work closely with cross-functional teams, leverage up-to-date technology platforms, and engage in ongoing education about regulatory requirements. Strong analytical skills help them assess and negotiate pricing strategies, while effective communication ensures all stakeholders are informed and aligned. By proactively managing these factors, PBMs play a key role in keeping healthcare affordable and accessible.
To thrive as a Pharmacy Benefit Manager (PBM), you need a solid understanding of pharmacy benefits, healthcare administration, insurance processes, and data analysis, often supported by a degree in pharmacy, healthcare management, or a related field. Familiarity with pharmacy claims processing systems, formulary management software, and compliance regulations is essential, and some roles may require pharmacy technician or pharmacist certification. Strong communication, negotiation, and organizational skills help PBMs collaborate with pharmacies, insurers, and clients while managing complex benefit structures. These capabilities are crucial for ensuring cost-effective, compliant, and efficient pharmacy benefit solutions for clients and patients.
A PBM (Pharmacy Benefit Manager) job involves managing prescription drug benefits on behalf of health insurers, employers, and other payers. Responsibilities often include negotiating drug prices with manufacturers, creating formularies, processing pharmacy claims, and ensuring medication cost savings. PBM professionals work in roles such as clinical pharmacists, account managers, and analysts to optimize drug coverage and improve patient outcomes.

$19.22 - $34.90/hr
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 7 days ago
7.7
Based on 348 frontline employees who took The Breakroom Quiz
198th of 299 rated insurance
Anticipated End Date:
2026-08-14Position Title:
PBM Billing Specialist SeniorJob Description:
PBM Billing Specialist Senior
Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
CarelonRx is a proud member of the Elevance Health family of companies. CarelonRx pairs a strong, clinical-first lens with deep pharmacy expertise to create solutions that improve outcomes, control costs, and enhance each member's health.
The PBM Billing Specialist Senior is responsible forassembling and maintaining all necessary documentation for billing purposes.
How you will make an impact:
Minimum Qualifications:
Preferred Skills, Capabilities and Experiences:
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $19.22/hour - $34.90/hour.
Locations: Columbus, OH; Cleveland, OH; Virginia
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee
Job Level:
Non-Management Non-ExemptWorkshift:
1st Shift (United States of America)Job Family:
AFA > Financial OperationsPlease be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.
NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words - the job is posted until 3/13, not through 3/13.
Get the full story on Breakroom
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Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
Health care and social assistance
10,000+ Employees
Indianapolis, IN, US
2004