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Pharmacy Benefit Coder Jobs (NOW HIRING)

Western Growers Family of Companies

Plan Coder

$44K - $65K/yr

SUMMARY Position reports to the Supervisor Benefit Distribution & Installation and performs in-depth pharmacy and medical plan coding of new and existing business accounts. This position will ensure ...

TTF Search and Staffing

CPC Coder- Onsite

Phoenix, AZ · Remote

$22.50 - $30/hr

... pharmaceutical and pharmacy benefit plan organizations, surgery centers, DME/home health ... The TTF Coding and HIM Division partners with healthcare organizations nationwide to match top ...

PacificSource

Pharmacy Technician II

Boise, ID

$16.75 - $20.25/hr

Coordinate application of pharmacy services and benefits as an integral contributor on the pharmacy ... Familiarity of CPT/ICD-10 codes, home infusion therapies, and specialty medications helpful.

PacificSource

Pharmacy Technician II

Springfield, OR

$18 - $22/hr

Coordinate application of pharmacy services and benefits as an integral contributor on the pharmacy ... Familiarity of CPT/ICD-10 codes, home infusion therapies, and specialty medications helpful.

PacificSource

Pharmacy Technician II

Springfield, OR · On-site

$18 - $22/hr

Coordinate application of pharmacy services and benefits as an integral contributor on the pharmacy ... Familiarity of CPT/ICD-10 codes, home infusion therapies, and specialty medications helpful.

PacificSource

Pharmacy Technician II

Portland, OR

$18.50 - $22.50/hr

Coordinate application of pharmacy services and benefits as an integral contributor on the pharmacy ... Familiarity of CPT/ICD-10 codes, home infusion therapies, and specialty medications helpful.

PacificSource

Pharmacy Technician II

Portland, OR

$18.50 - $22.50/hr

Coordinate application of pharmacy services and benefits as an integral contributor on the pharmacy ... Familiarity of CPT/ICD-10 codes, home infusion therapies, and specialty medications helpful.

PacificSource

Pharmacy Technician II

Boise, ID

$16.75 - $20.25/hr

Coordinate application of pharmacy services and benefits as an integral contributor on the pharmacy ... Familiarity of CPT/ICD-10 codes, home infusion therapies, and specialty medications helpful.

PacificSource

Pharmacy Technician II

Bend, OR

$18.50 - $22.50/hr

Coordinate application of pharmacy services and benefits as an integral contributor on the pharmacy ... Familiarity of CPT/ICD-10 codes, home infusion therapies, and specialty medications helpful.

PacificSource

Pharmacy Technician II

Portland, OR · On-site

$18.50 - $22.50/hr

Coordinate application of pharmacy services and benefits as an integral contributor on the pharmacy ... Familiarity of CPT/ICD-10 codes, home infusion therapies, and specialty medications helpful.

PacificSource Health Plans

Pharmacy Technician II

Bend, OR

$18.50 - $22.50/hr

Coordinate application of pharmacy services and benefits as an integral contributor on the pharmacy ... Familiarity of CPT/ICD-10 codes, home infusion therapies, and specialty medications helpful.

PacificSource

Pharmacy Technician II

Boise, ID · On-site

$16.75 - $20.25/hr

Coordinate application of pharmacy services and benefits as an integral contributor on the pharmacy ... Familiarity of CPT/ICD-10 codes, home infusion therapies, and specialty medications helpful.

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Pharmacy Benefit Coder information

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How much do pharmacy benefit coder jobs pay per hour?

As of Jul 21, 2026, the average hourly pay for pharmacy benefit coder in the United States is $19.27, according to ZipRecruiter salary data. Most workers in this role earn between $16.83 and $20.43 per hour, depending on experience, location, and employer.

What are some common challenges Pharmacy Benefit Coders face when interpreting complex insurance policies?

Pharmacy Benefit Coders often encounter challenges when interpreting the nuances of various insurance policies, particularly as formularies, coverage tiers, and reimbursement rules can frequently change. Keeping up-to-date with these policy updates and accurately translating them into coding systems requires attention to detail and strong analytical skills. Additionally, coders must collaborate closely with pharmacists and insurance specialists to clarify ambiguities and ensure accurate claims processing, which can be demanding in a fast-paced environment.

Is medical billing and coding worth it in 2026?

Pharmacy benefit coders and medical billing and coding professionals are expected to see steady demand through 2026 due to ongoing healthcare industry needs. These roles typically require certification and familiarity with coding systems like ICD-10 and CPT, and they often offer flexible schedules and remote work options. Job prospects remain favorable for those with relevant skills and certifications.

What is the difference between Pharmacy Benefit Coder vs Pharmacy Technician?

AspectPharmacy Benefit CoderPharmacy Technician
CredentialsCertification in coding or pharmacy benefit managementCertification or registration with pharmacy boards often required
Work EnvironmentInsurance companies, pharmacy benefit management firmsRetail pharmacies, hospitals, clinics
Job FocusAnalyzing and coding pharmacy benefit claims, ensuring proper reimbursementDispensing medications, assisting pharmacists, managing prescriptions

The main difference is that Pharmacy Benefit Coders focus on analyzing and coding pharmacy benefit claims for insurance reimbursement, while Pharmacy Technicians assist pharmacists with dispensing medications and managing prescriptions. Both roles require relevant certifications and are integral to pharmacy operations, but they serve distinct functions within the healthcare and pharmacy industry.

What pays more, CCS or CPC?

In the pharmacy benefit coding field, CCS (Certified Coding Specialist) typically offers higher salaries than CPC (Certified Professional Coder) due to its specialized focus on pharmacy and healthcare coding. CCS credential holders often have more advanced skills and may work in more complex environments, which can lead to higher pay. However, salaries vary based on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Pharmacy Benefit Coder, and why are they important?

To thrive as a Pharmacy Benefit Coder, you need a strong understanding of pharmacy benefit management, medical coding, and insurance processes, often supported by certification such as CPC or CPhT. Familiarity with pharmacy billing software, coding systems like ICD-10 and CPT, and claims processing tools is typically required. Strong attention to detail, analytical thinking, and effective communication skills help ensure accuracy and collaboration with healthcare teams. These skills are crucial for minimizing claim errors, ensuring regulatory compliance, and optimizing reimbursement for pharmacy services.

What are Pharmacy Benefit Coders?

Pharmacy Benefit Coders are professionals responsible for translating prescription drug information into standardized codes used for processing pharmacy claims and ensuring proper medication coverage under health insurance plans. They work closely with pharmacists, insurance companies, and healthcare providers to ensure accurate reimbursement and compliance with regulatory guidelines. Their role is crucial in managing formularies, resolving claim issues, and optimizing the efficiency of pharmacy benefit management.

Will AI eventually replace medical coders?

Pharmacy benefit coders play a crucial role in translating medical and pharmacy data into codes for billing and insurance purposes. While AI and automation tools are increasingly used to assist with coding tasks, human oversight remains essential to ensure accuracy and handle complex cases. Therefore, AI is likely to augment rather than fully replace pharmacy benefit coders in the foreseeable future.

Is ICD coding difficult?

ICD coding for a Pharmacy Benefit Coder involves understanding medical diagnoses and applying standardized codes, which requires attention to detail and familiarity with coding guidelines. While it can be complex initially, training and practice help develop proficiency, and certifications like CPC can improve skills. The job often involves working with electronic health records and coding software in a structured environment.
More about Pharmacy Benefit Coder jobs
What states have the most Pharmacy Benefit Coder jobs? States with the most job openings for Pharmacy Benefit Coder jobs include:
What job categories do people searching Pharmacy Benefit Coder jobs look for? The top searched job categories for Pharmacy Benefit Coder jobs are:
Pharmacy Benefit Coder jobs near you
Pharmacy Benefits Verification Specialist

Pharmacy Benefits Verification Specialist

Onco360

Buffalo, NY • On-site

$22/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Job description

Are you someone looking for professional career growth? Onco360 Pharmacy is looking for Pharmacy Benefit Verification Specialists for our Pharmacy located in Buffalo, NY.
Shift time: Monday through Friday 10am-6:30 pm EST.
Starting salary at $22/HR and up
Sign-On Bonus: $5,000 for employees starting before August 31, 2026.
We also offer quarterly incentive bonuses.
We offer a variety of benefits including:
  • Medical, Dental & Vision insurance
  • 401k with a match
  • Paid Time Off and Paid Holidays
  • Tuition Reimbursement
  • Paid Volunteer Day
  • Floating Holiday
  • Referral Incentive
  • Paid Life, and short & long-term disability insurance
Pharmacy Benefit Verification Summary
The Benefit Verification Specialist will investigate, review, and load accurate patient insurances, including medical and pharmacy coverage, assign coordination of benefits, run test claims to obtain a valid insurance response on patient medications, investigate/identify authorization requirements needed to obtain medication coverage, and enroll eligible patients in copay card assistance programs. They will ensure accurate benefit documentation is made for all prescription orders.
Pharmacy Benefit Verification Specialist Major Responsibilities:
  • 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 benefit information.
  • Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information.
  • Performs full benefits verification on patients for pharmacy benefits and/or medical benefit utilizing electronic resources and E1 check to load primary, secondary, tertiary, etc. insurances and medical insurances to patient profile.
  • Run test claims at each licensed pharmacy site to obtain a valid claim response and determine optimal reimbursement, then document outcome of benefits review in CPR+ system to be used by operations and ensure the order is assigned to the appropriate dispensing pharmacy.
  • Facilitate process for requesting medical authorizations, LOAs, and TOAs for applicable commercial, Medicaid, and Medicare, or facility medication claims.
  • 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 Benefit Verification Specialist Qualifications:
  • Education/Learning Experience
    • Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification
    • Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician (PTCB), Specialty pharmacy experience
  • Work Experience
    • Required: 1+ years pharmacy or benefit verification experience
    • Desired: 3+ years pharmacy or benefit verification experience
  • Skills/Knowledge:
    • Required: Pharmacy insurance and benefit verification, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, 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.
  • 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 skill

Onco360 is a Closed door specialty pharmacy that focuses on patients who are currently undergoing cancer treatment. Our patients are important to us, so we always strive to meet and exceed their needs. We are seeking Pharmacy Benefit Verification Specialists who go above and beyond for our patients, and also passionate about helping others.

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