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Pharmacy Claims Jobs (NOW HIRING)

BrightSpring

Pharmacy Claims Processor / Remote

Louisville, KY · Remote

$15.50 - $19.75/hr

Our Company PharMerica Overview Step Into a Rewarding Role as an LTC Pharmacy Claims Specialist with PharMerica! Are you ready to make a real impact in a growing organization? Join our PharMerica ...

Conduent, Inc.

Pharmacy Claims Auditor CPhT

Miami, FL · Hybrid

$57K/yr

Pharmacy Claims Auditor CPhT Do you have a CPhT certification? Would you like to audit pharmacy claims for accuracy? About the Role Conduent Payment Integrity Solutions performs in depth pharmacy ...

PharMerica

Pharmacy Claims Processor / Remote

Louisville, KY · On-site +1

$15.50 - $19.75/hr

Leverage your Pharmacy Claims Experience to manage and resolve claims efficiently, ensuring our clients get the support they need. * Be a vital part of a team that's dedicated to enhancing patient ...

BrightSpring

Pharmacy Claims Processor / Remote

Louisville, KY · Remote

$15.50 - $19.75/hr

Leverage your Pharmacy Claims Experience to manage and resolve claims efficiently, ensuring our clients get the support they need. * Be a vital part of a team that's dedicated to enhancing patient ...

Amerita

Pharmacy Claims Processor / Remote

Louisville, KY · On-site +1

$15.50 - $19.75/hr

Leverage your Pharmacy Claims Experience to manage and resolve claims efficiently, ensuring our clients get the support they need. * Be a vital part of a team that's dedicated to enhancing patient ...

Conduent, Inc.

Pharmacy Claims Auditor CPhT

Miami, FL · On-site

$57K/yr

Pharmacy Claims Auditor CPhT Do you have a CPhT certification? Would you like to audit pharmacy claims for accuracy? About the Role Conduent Payment Integrity Solutions performs in depth pharmacy ...

Insight Global

Pharmacy Benefits Specalist

Robinson, PA · On-site

$21 - $23/hr

One year of Pharmacy Experience, having resolved third party claims * Healthcare industry experience with claims background * Strong technical aptitude and ability to learn complex new software A ...

RiteChoice Rx

Claims Auditor

Pharmacy auditing, medical billing auditing, or pharmacy technician experience is strongly preferred. Supervision The Claims Auditor will report directly to the Compliance Manager. * This is a ...

Actalent

100% Remote Pharmacy Technician

$18 - $21.75/hr

100% REMOTE Pharmacy Technician The Pharmacy Technician supports multiple pharmacy operations areas ... Review paid claims for quantity and billing discrepancies and communicate findings to pharmacies.

Actalent

100% REMOTE Pharmacy Technician

$18 - $21.75/hr

100% REMOTE Pharmacy Technician The Pharmacy Technician supports multiple pharmacy operations areas ... Review paid claims for quantity and billing discrepancies and communicate findings to pharmacies.

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How much do pharmacy claims jobs pay per hour?

As of Aug 21, 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 is a pharmacy claims?

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.

What are the key skills and qualifications needed to thrive in pharmacy claims, 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 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.

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What are the most commonly searched types of Pharmacy Claims jobs?

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Pharmacy Claims jobs near you
Infographic showing various Pharmacy Claims job openings in the United States as of August 2026, with employment types broken down into 1% Internship, 1% As Needed, 69% Full Time, 27% Part Time, and 2% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $61,156 per year, or $29.4 per hour.

Pharmacy Claims Processor / Remote

BrightSpring

Louisville, KY • Remote

$15.50 - $19.75/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 4 days ago

Job description

Our Company
PharMerica
Overview
Step Into a Rewarding Role as an LTC Pharmacy Claims Specialist with PharMerica!
Are you ready to make a real impact in a growing organization? Join our PharMerica team as a Claims Specialist, where you'll play a key role in ensuring our long-term care and senior living clients receive the pharmaceutical support they need. We offer a non-retail, closed-door pharmacy environment, allowing you to focus on what truly matters-delivering exceptional care and service.
Why Join PharMerica?
  • Focused on Service Excellence: Our mission is to provide top-quality care and outstanding customer service to hospitals, rehabilitation centers, long-term acute care hospitals, and specialized care centers across the nation.
  • Career Growth: We're in high growth mode, offering plenty of opportunities for those looking to advance their careers.
  • Remote Flexibility: This position is 100% remote, giving you the freedom to work from anywhere!

What You'll Do: As a dynamic Claims Specialist, you will:
  • Leverage your Pharmacy Claims Experience to manage and resolve claims efficiently, ensuring our clients get the support they need.
  • Be a vital part of a team that's dedicated to enhancing patient care through meticulous claims management and customer service.
Shift: Evening/night must include a weekend. Shift differentials are availbale.
Must have pharmacy claims or adjudication background.
What We Offer:
  • DailyPay
  • Flexible Schedules
  • Competitive Pay with Shift Differentials
  • Health, Dental, Vision, and Life Insurance
  • Company-Paid Disability Insurance
  • Tuition Assistance & Reimbursement
  • Employee Discount Program
  • 401k Plan
  • Paid Time Off
  • Non-Retail, Closed-Door Environment

Responsibilities
The Claims Specialist - 3rd Party:
  • Manages and identifies a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks
  • Researches, analyzes and appropriately resolves rejected claims by working with national Medicare D plans, third party insurance companies and all state Medicaid plans to ensure maximum payer reimbursement adhering to critical deadlines
  • Ensures approval of claims by performing appropriate edits and/or reversals to ensure maximum payer reimbursement
  • Monitors and resolves at risk revenue associated with payer set up, billing, rebilling and reversal processes
  • Works as a team to identify, document, communicate and resolve payer/billing trends and issues
  • Reviews and works to convert billing exception reports to ensure claims are billed to accurate financial plans
  • Prepares and maintains reports and records for processing
  • Performs other tasks as assigned

Qualifications
Education/Learning Experience:
  • Required: High School Diploma or GED
  • Desired: Associate's or Bachelor's Degree
Work Experience:
  • Required: Customer Service
  • Desired: Up to one year of related experience. Pharmacy Technician experience
Skills/Knowledge:
  • Required: Ability to retain a large amount of information and apply that knowledge to related situations. Ability to work in a fast-paced environment. Basic math aptitude. Microsoft Office Suite
  • Desired: Knowledge of the insurance industry's trends, directions, major issues, regulatory considerations and trendsetters
Licenses/Certifications:
  • Desired: Pharmacy technician, but not required

About our Line of Business
PharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.
Additional Job Information
This is an excellent opportunity to move from a retail to office environment for those who are willing to learn claims, billing and insurance processing.
Pharmacy Technician experience and/or knowledge of pharmaceuticals is a strong preference.