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Remote Insurance Verification Jobs in Albuquerque, NM

BCForward

Customer Service Representative

Albuquerque, NM · Remote

$19 - $19.90/hr

Remote (Local to State of New Mexico) Expected Duration: 12+ months contract (with possible ... insurance, short-term disability, long-term disability, and 401k. About BC forward : Founded in ...

One Generation Fund

Finance Coordinator

Corrales, NM · Remote

$44K - $66K/yr

Verify that each payment request includes complete documentation. * Process expense reimbursements ... Location: One Generation Fund is a remote organization. This role can be based anywhere in the ...

Getaway

Customer Representative

Albuquerque, NM · Remote

$30K - $50K/yr

Perks * 100% remote work with flexible scheduling. * Opportunities for growth within the agency. * Travel perks and exclusive industry discounts. * Supportive team environment with ongoing training.

Getaway

Customer Representative

Albuquerque, NM · Remote

$30K - $50K/yr

Perks * 100% remote work with flexible scheduling. * Opportunities for growth within the agency. * Travel perks and exclusive industry discounts. * Supportive team environment with ongoing training.

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Remote Insurance Verification information

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$24

How much do remote insurance verification jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for remote insurance verification in Albuquerque, NM is $17.24, according to ZipRecruiter salary data. Most workers in this role earn between $14.95 and $18.46 per hour, depending on experience, location, and employer.

What is a remote insurance verification specialist?

A Remote Insurance Verification Specialist is a professional who works from a remote location to confirm patients' insurance coverage and benefits. They communicate with insurance companies, healthcare providers, and patients to ensure that medical procedures or services are covered by the patient's insurance plan. These specialists play a crucial role in preventing billing issues and ensuring that claims are processed accurately and efficiently. Their work helps healthcare organizations minimize denials and delays in reimbursement. The position typically requires strong communication skills, attention to detail, and familiarity with insurance policies and medical terminology.

What are some common challenges faced in a remote insurance verification role, and how can I overcome them?

In a remote insurance verification role, one common challenge is navigating varying insurance policies and provider requirements, which can lead to delays or errors if not carefully reviewed. Communication can also be more complex when collaborating virtually with healthcare providers, patients, or insurance companies. To overcome these challenges, staying organized with detailed documentation, utilizing reliable communication tools, and proactively clarifying any uncertainties with team members or clients can help maintain efficiency and accuracy. Regular training and staying updated on industry changes also contribute to success in this role.

What are the key skills and qualifications needed to thrive as a remote insurance verification specialist, and why are they important?

To thrive as a Remote Insurance Verification Specialist, you need a solid understanding of health insurance policies, medical terminology, and experience with insurance verification processes, often supported by a high school diploma or relevant certification. Proficiency in insurance portals, electronic health record (EHR) systems, and spreadsheet software is typically required. Strong attention to detail, organizational skills, and effective communication are essential soft skills for handling sensitive patient data and coordinating with providers. These abilities are vital to ensure accurate insurance verification, prevent claim denials, and support smooth healthcare operations.

What is the difference between Remote Insurance Verification vs Remote Claims Processing Specialist?

AspectRemote Insurance VerificationRemote Claims Processing Specialist
Primary RoleVerify insurance coverage and eligibilityReview and process insurance claims for reimbursement
Required SkillsKnowledge of insurance policies, data entry, attention to detailClaims review, documentation, problem-solving
Work EnvironmentRemote, healthcare or insurance companiesRemote, healthcare or insurance companies
CertificationsInsurance verification or billing certifications often preferredClaims processing certifications may be beneficial

Remote Insurance Verification and Remote Claims Processing Specialist roles both operate in the insurance and healthcare industries, often remotely. While verification focuses on confirming coverage details, claims processing involves reviewing and managing claims for reimbursement. Both roles require attention to detail and familiarity with insurance policies, but they differ in their specific responsibilities and certifications.

How to become a remote insurance verification specialist?

To become a remote insurance verification specialist, candidates typically need a high school diploma or equivalent, strong attention to detail, and familiarity with insurance policies and billing procedures. Relevant skills include data entry, communication, and proficiency with electronic health record (EHR) systems or insurance verification software. Some employers may prefer candidates with healthcare or insurance industry experience and may require certification in medical billing or coding.
More about Remote Insurance Verification jobs

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Cities near Albuquerque, NM with the most Remote Insurance Verification job openings:

Remote Insurance Verification jobs near you
Infographic showing various Remote Insurance Verification job openings in Albuquerque, NM as of August 2026, with employment types broken down into 1% As Needed, 75% Full Time, 19% Part Time, and 5% Contract. Highlights an 84% Physical, 1% Hybrid, and 15% Remote job distribution, with an average salary of $35,861 per year, or $17.2 per hour.

Pharmacy Claims Adjudication Specialist

Onco360

Albuquerque, NM • Remote

$22/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 8 days ago

Onco360 rating

7.7

Company rating: 7.7 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

20th of 113 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 NEW MEXICO 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 $22.00 an hour and up
Sign-On Bonus: $5,000 for employees starting before October 31st, 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

What Onco360 employees say

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