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Remote Pharmacy Benefit Manager Jobs in Indiana (NOW HIRING)

Guardian Pharmacy

Pharmacy Billing Specialist

Indianapolis, IN · On-site +1

$18.50 - $24.75/hr

Why Guardian Pharmacy of Indiana? We're reimagining medication management and transforming care ... This position will begin onsite and may become hybrid or fully remote based on demonstrated ...

True Rx Management Services.

Dietitian

Washington, IN · Remote

... Remote What You'll Do: * One-on-One Counseling: Provide extensive nutritional and lifestyle ... account manager, educating clients on their benefit plans. * Program Implementation: Educate ...

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Remote Pharmacy Benefit Manager information

What is a remote pharmacy benefit manager?

A Remote Pharmacy Benefit Manager (PBM) is a professional who oversees prescription drug benefits for health plans, employers, and other clients while working from a remote location. Their responsibilities include managing formularies (lists of covered medications), negotiating with drug manufacturers and pharmacies, processing prescription claims, and ensuring cost-effective and appropriate medication use. Remote PBMs use specialized software and communication tools to perform their duties, which helps streamline operations and improve access to medications for members. This role typically requires knowledge of pharmacy practices, insurance processes, and regulatory compliance.

How does a remote pharmacy benefit manager typically collaborate with healthcare providers and insurance companies while working offsite?

As a Remote Pharmacy Benefit Manager, you'll frequently interact with healthcare providers and insurance companies through secure digital platforms, phone calls, and video conferences. Effective communication and relationship-building are essential, as you'll be responsible for clarifying coverage policies, resolving formulary issues, and negotiating drug pricing or rebates. Most remote teams use collaborative project management tools to stay aligned and ensure timely resolution of client and member needs. Although you may work independently, you'll regularly participate in virtual team meetings to share updates and best practices.

What are the key skills and qualifications needed to thrive as a remote pharmacy benefit manager, and why are they important?

To thrive as a Remote Pharmacy Benefit Manager, you need a strong background in pharmacy, healthcare administration, or a related field, often supported by a PharmD, RPh, or relevant degree. Familiarity with pharmacy benefit management (PBM) software, claims processing systems, and knowledge of pharmacy law and regulations is typically required. Exceptional analytical skills, attention to detail, and effective communication are key soft skills for managing client relationships and resolving issues. These competencies ensure accurate benefit administration, regulatory compliance, and high client satisfaction in a remote work environment.

What is the difference between Remote Pharmacy Benefit Manager vs Remote Pharmacy Technician?

AspectRemote Pharmacy Benefit ManagerRemote Pharmacy Technician
CredentialsCertification in pharmacy benefit management, sometimes a pharmacy technician licenseState pharmacy technician license, certification (e.g., PTCB)
Work EnvironmentCorporate offices, health plan providers, remote optionsPharmacy settings, mail-order pharmacies, remote roles
Employer & IndustryHealth insurance companies, pharmacy benefit management firmsRetail pharmacies, hospitals, mail-order pharmacies
Search & Comparison IntentUnderstanding roles in pharmacy benefits management, remote opportunitiesPharmacy technician duties, remote pharmacy roles

The main difference is that Remote Pharmacy Benefit Managers focus on managing pharmacy benefits, claims, and formulary decisions, often requiring knowledge of insurance and benefit plans. Remote Pharmacy Technicians assist pharmacists with dispensing medications, handling prescriptions, and customer service. Both roles may be remote but serve different functions within the pharmacy industry.

What are popular job titles related to Remote Pharmacy Benefit Manager jobs in Indiana?

For Remote Pharmacy Benefit Manager jobs in Indiana, the most frequently searched job titles are:

What job categories do people searching Remote Pharmacy Benefit Manager jobs in Indiana look for?

The top searched job categories for Remote Pharmacy Benefit Manager jobs in Indiana are:

What cities in Indiana are hiring for Remote Pharmacy Benefit Manager jobs?

Cities in Indiana with the most Remote Pharmacy Benefit Manager job openings:

Remote Pharmacy Benefit Manager jobs near you

Pharmacy Benefit Verification Specialist

Onco360

Indianapolis, IN • Remote

$24/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 4 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

Onco360 Pharmacy is looking for Pharmacy Benefit Verification Specialists for our Specialty Oncology Pharmacy.
As our company continues to grow, we strive to hire new team members with a passion for making a difference in our patient's lives.
Full-Time position may work remotely but MUST HAVE ACTIVE INDIANA PHARMACY TECHNICIAN credentials from the State Board of Pharmacy.
Shift times are between 8am and 8pm.
**Starting salary at $24HR and up**
Sign-On Bonus: $5,000 for employees starting before September 30th, 2026.
We also offer quarterly incentive bonuses.
We offer a variety of benefits including:
  • Medical, Dental amp; Vision insurance
  • 401k with a match
  • Paid Time Off and Paid Holidays
  • Tuition Reimbursement
  • Paid Volunteer Day
  • Floating Holiday
  • Referral Incentive
  • Paid Life, and short amp; long-term disability insurance
Pharmacy Benefit Verification Summary
The Benefit Verification Specialist will investigate, review, and load accurate patient insurances, including medical and pharmacy coverage, assign coordination of benefits, run test claims to obtain a valid insurance response on patient medications, investigate/identify authorization requirements needed to obtain medication coverage, and enroll eligible patients in copay card assistance programs. They will ensure accurate benefit documentation is made for all prescription orders.
Pharmacy Benefit Verification Specialist Major Responsibilities:
  • 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 benefit information.
  • Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information.
  • Performs full benefits verification on patients for pharmacy benefits and/or medical benefit utilizing electronic resources and E1 check to load primary, secondary, tertiary, etc. insurances and medical insurances to patient profile.
  • Run test claims at each licensed pharmacy site to obtain a valid claim response and determine optimal reimbursement, then document outcome of benefits review in CPR+ system to be used by operations and ensure the order is assigned to the appropriate dispensing pharmacy.
  • Facilitate process for requesting medical authorizations, LOAs, and TOAs for applicable commercial, Medicaid, and Medicare, or facility medication claims.
  • 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 Benefit Verification Specialist Qualifications:
  • Education/Learning Experience
    • Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification
    • Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician (PTCB), Specialty pharmacy experience
  • Work Experience
    • Required: 1+ years pharmacy or benefit verification experience
    • Desired: 3+ years pharmacy or benefit verification experience
  • Licenses/Certifications
    • Required: Pharmacy Technician License/Registration with Board of Pharmacy, as required by state law
  • Skills/Knowledge:
    • Required: Pharmacy insurance and benefit verification, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, 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.
  • 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 skill
Onco360 is a Closed door specialty pharmacy that focuses on patients who are currently undergoing cancer treatment. Our patients are important to us, so we always strive to meet and exceed their needs. We are seeking Pharmacy Benefit Verification Specialists who go above and beyond for our patients, and also passionate about helping others.

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