ZipRecruiter

Log In

2

Pharmacy Claims Remote Jobs (NOW HIRING)

CareMed Specialty Pharmacy

$23/hr

This is a remote hybrid opportunity, after onsite training period. Shift time currently available ... The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for ...

next page

Showing results 1-20

All JobsPharmacy Claims JobsPharmacy Claims Remote Jobs

Pharmacy Claims Remote information

See salary details

$15

$29

$45

How much do pharmacy claims remote jobs pay per hour?

As of Jun 15, 2026, the average hourly pay for pharmacy claims remote 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.

How does a Pharmacy Claims Remote professional typically collaborate with other team members when working from home?

Pharmacy Claims Remote professionals frequently interact with pharmacists, insurance representatives, and other claims specialists using virtual communication tools like email, chat, and video conferencing. While most tasks are individually completed, such as reviewing and processing claims, there are regular team meetings to discuss complex cases or policy updates. Clear communication and timely responses are essential to ensure claims are handled efficiently and in compliance with regulations. The remote setting requires proactive engagement with team members to address any issues and maintain workflow continuity.

What are the key skills and qualifications needed to thrive as a Pharmacy Claims Remote Specialist, and why are they important?

To thrive as a Pharmacy Claims Remote Specialist, you need strong attention to detail, knowledge of pharmacy operations, and familiarity with insurance claim processes, often supported by a pharmacy technician certification or relevant experience. Proficiency with pharmacy benefit management (PBM) systems, claims processing software, and electronic health record (EHR) platforms is typically required. Excellent communication, problem-solving, and organizational skills help you efficiently resolve claim issues and support customers remotely. These skills ensure accurate claims processing, regulatory compliance, and high-quality service for patients and providers.

What are pharmacy claims remote jobs?

Pharmacy claims remote jobs involve processing and reviewing prescription drug claims for insurance companies, pharmacy benefit managers, or healthcare organizations from a remote location. These roles typically require knowledge of pharmacy billing, insurance procedures, and healthcare regulations. Employees in these positions may verify coverage, resolve claim discrepancies, and communicate with pharmacies, patients, or insurance providers. Strong attention to detail and computer skills are important, and some positions may require pharmacy technician certification or prior experience in claims processing.
More about Pharmacy Claims Remote jobs
What cities are hiring for Pharmacy Claims Remote jobs? Cities with the most Pharmacy Claims Remote 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 Remote jobs? States with the most job openings for Pharmacy Claims Remote jobs include:
What job categories do people searching Pharmacy Claims Remote jobs look for? The top searched job categories for Pharmacy Claims Remote jobs are:
Pharmacy Claims Remote jobs near you
Infographic showing various Pharmacy Claims Remote job openings in the United States as of June 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $61,156 per year, or $29.4 per hour.
Pharmacy Claims Adjudication Specialist

Pharmacy Claims Adjudication Specialist

Onco360

Scottsdale, AZ • Remote

$23/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 11 days ago

Job description

W e are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy in Scottsdale, AZ. This will be a Full-Time position. This is a remote hybrid opportunity, after onsite training period.
Shift time currently available: 8:30 am-5:00 pm MST
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
Sign-On Bonus: $5,000 for employees starting before July 31, 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.
  • Documents 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
    • 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
#Company Values: Teamwork, Respect, Integrity, Passion
#IH
Employment Type: Full Time

Apply