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$15

$29

$45

How much do pharmacy claims jobs pay per hour?

As of Jul 31, 2026, the average hourly pay for pharmacy claims 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 some common challenges faced in a Pharmacy Claims role and how are they managed?

One common challenge in Pharmacy Claims is navigating complex insurance policies and resolving claim denials, which requires close attention to detail and a good grasp of industry guidelines. Professionals in this field frequently interact with pharmacists, healthcare providers, and insurance representatives to clarify coverage issues and expedite claim approvals. Staying up-to-date on changes in reimbursement policies and regulations is essential to avoid processing errors. Many employers offer ongoing training and support to help Pharmacy Claims specialists manage these challenges efficiently and maintain high-quality service.

What are the key skills and qualifications needed to thrive in the Pharmacy Claims position, and why are they important?

To thrive in Pharmacy Claims, you need a solid understanding of pharmacy benefit management, medical terminology, and claims processing, often supported by experience in healthcare or a related certification such as Pharmacy Technician Certification (CPhT). Familiarity with claims adjudication software, pharmacy management systems, and insurance platforms is typically required. Strong attention to detail, problem-solving skills, and clear communication abilities distinguish top performers in this field. These skills ensure accuracy, timely resolution of claims, and effective collaboration with pharmacists, insurers, and patients.

What is a Pharmacy Claims job?

A Pharmacy Claims job involves processing, reviewing, and resolving insurance claims related to prescription medications. Professionals in this role work with pharmacies, insurance providers, and patients to ensure claims are accurately submitted and reimbursed. Responsibilities may include verifying patient eligibility, troubleshooting rejected claims, and ensuring compliance with insurance policies. Strong attention to detail and knowledge of pharmacy billing codes are essential for success in this field.

More about Pharmacy Claims jobs
What cities are hiring for Pharmacy Claims jobs? Cities with the most Pharmacy Claims job openings:
What are the most commonly searched types of Pharmacy Claims jobs? The most popular types of Pharmacy Claims jobs are:
What states have the most Pharmacy Claims jobs? States with the most job openings for Pharmacy Claims jobs include:
What job categories do people searching Pharmacy Claims jobs look for? The top searched job categories for Pharmacy Claims jobs are:
Pharmacy Claims jobs near you
Infographic showing various Pharmacy Claims job openings in the United States as of July 2026, with employment types broken down into 91% Full Time, 7% Part Time, and 2% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $61,156 per year, or $29.4 per hour.

Pharmacy Claims Review Manager

Consonus Pharmacy

Portland, OR • On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 16 days ago

Job description

Overview
Pharmacy Claims Manager
What's your wish list for the perfect job? Maybe it's to make a positive impact in the world, or to grow your career in healthcare. Maybe working with a supportive team is top priority, or to feel respected and valued.
If your answer is "all of the above," consider joining our team at Consonus Pharmacy. It's a perfect opportunity for compassionate people dedicated to people's health and well-being.
Consonus Pharmacy is a closed-door long-term care pharmacy specializing in the needs of nursing facilities, assisted living residents, and their caregivers. We are currently hiring a Pharmacy Claims Manager to join our team!
As the Pharmacy Claims Manager your responsibilities will include (but are not limited to):
The Pharmacy Claims Manager is responsible for overseeing all pharmacy claims processing operations, including prescription adjudication, third-party billing, claim rejection management, and reimbursement optimization. This position leads a team responsible for ensuring accurate and timely claim submission, resolution of claim exceptions, compliance with PBM, Medicare Part D, Medicaid, and commercial payer requirements, and adherence to NCPDP standards.
The Pharmacy Claims Manager partners closely with Billing, Customer Accounts, and Pharmacy Operations to ensure accurate reimbursement and compliance, minimize claim write-offs, and ensure exceptional service to residents, facilities, and payers. In our Long-Term Care environment, there is focus on coordination with the Credentialing & Contracting team on payer enrollment issues, and management of LTC-specific reject queues related to transition fills, hospice billing, and facility census changes.
Some benefits may include:
  • Paid training & career advancement opportunities
  • $25,000 toward ongoing education benefit
  • Generous Paid Time Off that pools vacation, sick & holiday pay in a single bucket for flexible use
  • Medical/Dental/Vision insurance
  • Free access to MDLIVE - allowing access to your health benefits from anywhere
  • 401K With Employer Match
  • Employee Assistance Program: with free access to counseling & support services

Qualifications
  • Bachelor's degree in Healthcare Administration, Business, Finance, or related field; equivalent experience considered.
  • Minimum 5 years of pharmacy claims, third-party billing, pharmacy revenue cycle, or PBM operations experience. Long - Term Care experience preferred.
  • Minimum 2 years of supervisory or management experience.
  • Strong understanding of: NCPDP claim standards, Medicare Part D, Medicaid pharmacy billing, Managed Care reimbursement, PBM claim adjudication processes, Pharmacy revenue cycle operations.
  • Experience working with PBMs such as Express Scripts, CVS Caremark, OptumRx, Humana, Prime Therapeutics, MedImpact, and Navitus.
  • Experience managing Medicare Part D, Medicaid, and dual-eligible populations
  • Advanced analytical and problem-solving skills.
  • Proficiency with pharmacy management systems and reporting tools
  • Ability to work under pressure in fast-paced environment ensuring timely and accurate billing
  • Ability to travel to other pharmacy locations as required
  • Certified Pharmacy Technician (CPhT) preferred (can obtain after hire)

EEO Statement
"Be here. Be you."
For more than 30 years, Marquis Companies and Consonus Healthcare have been serving seniors and welcoming staff of all backgrounds, skills, and perspectives. The Marquis family of companies offer a rich heritage of embracing differences and honoring individuality. We've continued to grow in our appreciation of diversity in the workplace. We know it builds strength, drives innovation, and brings valuable new perspectives and energy.
We're committed to making our workforce an even greater reflection of the people and communities we serve, and we are honored our employees have chosen to work at Marquis and Consonus. Everything we do as a company is driven by our mission to help those we serve, and each other, live the best rest of our lives.
That means you being you - without apology or compromise. We value your every uniqueness and continue to curate, nurture, and sustain an inclusive culture. It's the foundation of who we are and the evolution of our collective future.

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