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Remote Claims Associate information

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How much do remote claims associate jobs pay per hour?

As of Aug 4, 2026, the average hourly pay for remote claims associate in Colorado is $22.07, according to ZipRecruiter salary data. Most workers in this role earn between $17.93 and $24.28 per hour, depending on experience, location, and employer.

How does a remote claims associate collaborate with other team members while working from home?

As a Remote Claims Associate, you'll regularly communicate with team members, supervisors, and other departments through digital channels like email, instant messaging, and video conferencing. Collaboration often involves sharing updates on claim statuses, seeking guidance on complex cases, and participating in virtual team meetings. Many organizations use workflow management platforms and secure document-sharing tools to ensure seamless coordination and maintain data security. Building strong virtual communication skills is important to stay connected and contribute effectively to team goals.

What skills and qualifications are needed to be a remote claims associate?

To excel as a Remote Claims Associate, you typically need knowledge of insurance processes, attention to detail, and a high school diploma or relevant experience. Familiarity with claims management software, CRM systems, and sometimes specific certifications like AIC (Associate in Claims) are highly beneficial. Strong organizational skills, effective communication, and the ability to work independently are crucial soft skills for remote success. These competencies ensure accurate claims processing, customer satisfaction, and efficient remote workflow management.

What is a remote claims associate?

A Remote Claims Associate is a professional who reviews, processes, and manages insurance claims from a remote location, typically working from home. They evaluate claim details, verify information, and communicate with policyholders, service providers, and other stakeholders to ensure claims are handled accurately and efficiently. This role often requires strong attention to detail, good communication skills, and proficiency with digital tools and claims management software. Remote Claims Associates may work for insurance companies, third-party administrators, or other organizations handling claims. The position allows for flexibility in work location while maintaining high standards of customer service and accuracy.
What are the most commonly searched types of Remote Claims jobs in Colorado? The most popular types of Remote Claims jobs in Colorado are:
What are popular job titles related to Remote Claims Associate jobs in Colorado? For Remote Claims Associate jobs in Colorado, the most frequently searched job titles are:
What job categories do people searching Remote Claims Associate jobs in Colorado look for? The top searched job categories for Remote Claims Associate jobs in Colorado are:
What cities in Colorado are hiring for Remote Claims Associate jobs? Cities in Colorado with the most Remote Claims Associate job openings:
Remote Claims Associate jobs near you
Infographic showing various Remote Claims Associate job openings in Colorado as of July 2026, with employment types broken down into 100% Part Time. Highlights an 100% Remote job distribution, with an average salary of $45,902 per year, or $22.1 per hour.

Pharmacy Claims Adjudication Specialist

Onco360

Denver, CO • Remote

$24/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago

Onco360 rating

7.7

Company rating: 7.7 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

21st of 110 rated pharmacies

Job description

We are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy working in Mountain Time Zone. This will be a Full-Time position. This is a remote/hybrid opportunity,
Shift times start at 10am Mountain Time Zone until 8pm Mountain Time Zone.
Full-Time position may work remotely but MUST HAVE ACTIVE COLORADO PHARMACY TECHNICIAN credentials from the State Board of Pharmacy.
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 $24.00 an hour and up
Sign-On Bonus: $5,000 for employees starting before August 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.
  • Documenst 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

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