Qureos Mentor

Onco360

<div><div><b>Are you someone looking for professional career growth? </b>Onco360 Pharmacy is looking for <b>Pharmacy Benefit Verification Specialists</b> for our Pharmacy located in New Hyde Park<b>, NY</b><b>.</b></div>
<div></div><div><div><div><b>Shift times between 8am and 8pm.</b></div>
<div></div><div><b>**Starting salary at $25/HR and up**</b></div>
</div></div><div><b>Sign-On Bonus: </b><b>$5,000 for employees starting before August 31, 2026.</b></div>
<div></div><div>We also offer quarterly incentive bonuses.</div>
<div></div><div><div><div>We offer a variety of benefits including:</div>
<ul><li>Medical, Dental &amp; Vision insurance</li>
<li>401k with a match</li>
<li>Paid Time Off and Paid Holidays</li>
<li>Tuition Reimbursement</li>
<li>Paid Volunteer Day</li>
<li>Floating Holiday</li>
<li>Referral Incentive</li>
<li>Paid Life, and short &amp; long-term disability insurance</li>
</ul>
</div><div></div><div><div><div><b>Pharmacy </b><b>Benefit Verification</b><b> Summary</b></div>
<div>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.</div>
<div></div><div><b>Pharmacy </b><b>Benefit Verification</b><b> Specialist Major Responsibilities:</b></div>
<ul><li>Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests.</li>
<li>Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding benefit information.</li>
<li>Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information.</li>
<li>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.</li>
<li>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.</li>
<li>Facilitate process for requesting medical authorizations, LOAs, and TOAs for applicable commercial, Medicaid, and Medicare, or facility medication claims.</li>
<li>Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws</li>
<li>Contributes to team effort by accomplishing related tasks as needed and other duties as assigned.</li>
<li>Conducts job responsibilities in accordance with the standards set out in the Company&rsquo;s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.</li>
</ul></div><div><b>Pharmacy </b><b>Benefit Verification</b><b> Specialist Qualifications:</b></div>
</div><ul><li>Education/Learning Experience
<ul><li>Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification</li>
<li>Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician (PTCB), Specialty pharmacy experience</li>
</ul></li><li>Work Experience
<ul><li>Required: 1+ years pharmacy or benefit verification experience</li>
<li>Desired: 3+ years pharmacy or benefit verification experience</li>
</ul></li><li>Skills/Knowledge:
<ul><li>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.</li>
</ul></li><li>Behavior Competencies
<ul><li>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</li>
</ul></li></ul><div>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 <b>Pharmacy Benefit Verification Specialist</b>s who go above and beyond for our patients, and also passionate about helping others.</div></div></div>

Pharmacy Benefits Verification Specialist

<div><div><b>Are you someone looking for professional career growth? </b>Onco360 Pharmacy is looking for <b>Pharmacy Benefit Verification Specialists</b> for our Pharmacy located in <b>Buffalo, NY</b><b>.</b></div>
<div></div><div><div><b>Shift time: Monday through Friday 10am-6:30 pm EST.</b></div>
</div><div></div><div><b>**Starting salary at $22/HR and up**</b></div>
<div><b>Sign-On Bonus: </b><b>$5,000 for employees starting before August 31, 2026.</b></div>
<div></div><div>We also offer quarterly incentive bonuses.</div>
<div></div><div><div><div>We offer a variety of benefits including:</div>
<ul><li>Medical, Dental &amp; Vision insurance</li>
<li>401k with a match</li>
<li>Paid Time Off and Paid Holidays</li>
<li>Tuition Reimbursement</li>
<li>Paid Volunteer Day</li>
<li>Floating Holiday</li>
<li>Referral Incentive</li>
<li>Paid Life, and short &amp; long-term disability insurance</li>
</ul>
</div><div></div><div><div><div><b>Pharmacy </b><b>Benefit Verification</b><b> Summary</b></div>
<div>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.</div>
<div></div><div><b>Pharmacy </b><b>Benefit Verification</b><b> Specialist Major Responsibilities:</b></div>
<ul><li>Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests.</li>
<li>Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding benefit information.</li>
<li>Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information.</li>
<li>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.</li>
<li>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.</li>
<li>Facilitate process for requesting medical authorizations, LOAs, and TOAs for applicable commercial, Medicaid, and Medicare, or facility medication claims.</li>
<li>Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws</li>
<li>Contributes to team effort by accomplishing related tasks as needed and other duties as assigned.</li>
<li>Conducts job responsibilities in accordance with the standards set out in the Company&rsquo;s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.</li>
</ul></div><div><b>Pharmacy </b><b>Benefit Verification</b><b> Specialist Qualifications:</b></div>
</div><ul><li>Education/Learning Experience
<ul><li>Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification</li>
<li>Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician (PTCB), Specialty pharmacy experience</li>
</ul></li><li>Work Experience
<ul><li>Required: 1+ years pharmacy or benefit verification experience</li>
<li>Desired: 3+ years pharmacy or benefit verification experience</li>
</ul></li><li>Skills/Knowledge:
<ul><li>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.</li>
</ul></li><li>Behavior Competencies
<ul><li>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</li>
</ul></li></ul><div>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 <b>Pharmacy Benefit Verification Specialist</b>s who go above and beyond for our patients, and also passionate about helping others.</div></div></div>

<div><div><b>Onco360 is continuing to grow, and we're seeking new team members. Join a mission-driven team making a difference in the lives of cancer patients.</b></div>
<div></div><div>Pharmacy Patient Advocacy Coordinator / Patient Assistance Program<b> &ndash; Onco360 Pharmacy</b></div>
<div><b><i>Louisville, KY </i></b><b>| </b><b><i>Full-Time</i></b><b> | </b><b><i>Mon - Fri 11:30am to 8pm EST</i></b></div>
<div><b><i>Salary</i></b><b> </b><b><i>Starting at $22.00/hr and up</i></b></div>
<div></div><div><b>Sign-On Bonus: </b>$5,000 for employees starting before August 31, 2026.</div>
<div></div><div>Onco360, a leading oncology pharmacy, is seeking a <b>Pharmacy Patient Advocacy Coordinator. -
</b></div><div><b>Must live within commuting distance of our Louisville pharmacy.</b> <b>Remote work possible after initial on-site training.</b></div>
<div></div><div><b>Ready to make a meaningful impact? Apply today and help us better the lives of those battling cancer.</b></div>
<div></div><div><b>Company Benefits</b></div>
<ul><li>Medical; Dental; Vision</li>
<li>401k opportunity</li>
<li>Paid Time Off and Paid Holidays</li>
<li>Tuition Reimbursement</li>
<li>Quarterly Incentive Bonus</li>
<li>Paid Volunteer Day</li>
<li>Referral Incentive Program</li>
<li>Company Paid Life Insurance; and Short/Long-Term Disability</li>
</ul> <p></p><div><b>Why Join Us?</b></div>
<ul><li>A career with purpose: Help patients access life-saving medications.</li>
<li>Supportive culture: We value <b>teamwork, respect, integrity, and passion</b>.</li>
<li>Growth opportunities: We invest in your professional and personal development.</li>
</ul><p></p><div><b>What You&rsquo;ll Do</b></div>
 <div>The <b>Patient Advocacy Coordinator</b> is responsible for assisting patients and/or families to access financial resources for Pharmacy co-pays. The Advocacy Coordinator assists patients who may qualify for assistance through Not for Profit Organizations and Manufacturer Programs. They are responsible for navigating the system to find resources that best fits the patient&rsquo;s needs, aid patients by explaining the process, assist in filling out applications and going over the documents that will be required to complete the application.</div>
<div></div><div><b>How You&rsquo;ll Do This</b></div>
<ul><li>Practice first call resolution to assist patients and families in securing financial assistance for pharmacy co-pays.</li>
<li>Maintain a working knowledge of health insurance and pharmacy benefit coverage, cancer diagnoses and drugs used in their treatment.</li>
<li>Support applications for nonprofit and manufacturer assistance programs.</li>
<li>Provide clear explanations of insurance benefits and co-pay structures.</li>
<li>Maintain accurate patient demographic and insurance data in CPR+.</li>
<li>Collaborate with pharmacy operations and cross-functional teams to ensure seamless service.</li>
</ul> <p></p><div><b>What You Bring</b></div>
<div><b>Required:</b></div>
<ul><li>High School Diploma or GED</li>
<li>1+ years of patient assistance or advocacy experience</li>
<li>Registration with Board of Pharmacy (as required by state law)</li>
<li>Strong communication, organizational, and customer service skills</li>
</ul><div><b>Preferred:</b></div>
<ul><li>Associate degree or Certified Pharmacy Technician (PTCB)</li>
<li>3+ years of patient assistance or advocacy experience</li>
<li>Specialty pharmacy experience</li></ul></div><p></p>

Pharmacy Patient Advocacy Coordinator / Patient Assistance Programs

<div><div><div><b>Onco360 is continuing to grow, and we're seeking new team members. Join a mission-driven team making a difference in the lives of cancer patients. </b><b>Ready to make a meaningful impact? Apply today.</b></div>
</div>
<div></div><div><b>Patient Advocacy Coordinator / Patient Assistance Program &ndash; Onco360 Pharmacy</b></div>
<div><b><i>Scottsdale, AZ </i></b><b>| </b><b><i>Full-Time</i></b><b>
</b></div><div><b><i>Mon - Fri 8:30am to 5pm MST in spring/summer, shifting </i></b><b><i>with time change to </i></b><b><i>9:30am to 6pm MST in fall/winter</i></b></div>
<div><b>Salary </b><b><i>Starting at $23.00/hr and up</i></b></div>
<div></div><div><b>Sign-On Bonus: </b>$5,000 for employees starting before August 31, 2026.</div>
<div></div><div>Onco360, a leading oncology pharmacy, is seeking a <b>Patient Advocacy Coordinator.
</b></div><div>Must live within commuting distance of our Scottsdale pharmacy. <b>Remote work possible after initial on-site training.</b></div>
<div></div><div><b>Company Benefits</b></div>
<ul><li>Medical; Dental; Vision</li>
<li>401k opportunity</li>
<li>Paid Time Off and Paid Holidays</li>
<li>Tuition Reimbursement</li>
<li>Quarterly Incentive Bonus</li>
<li>Paid Volunteer Day</li>
<li>Referral Incentive Program</li>
<li>Company Paid Life Insurance; and Short/Long-Term Disability</li>
</ul> <p></p><div><b>Why Join Us?</b></div>
<ul><li>A career with purpose: Help patients access life-saving medications.</li>
<li>Supportive culture: We value <b>teamwork, respect, integrity, and passion</b>.</li>
<li>Growth opportunities: We invest in your professional and personal development.</li>
</ul><p></p><div><b>What You&rsquo;ll Do</b></div>
 <div>The <b>Patient Advocacy Coordinator</b> is responsible for assisting patients and/or families to access financial resources for Pharmacy co-pays. The Advocacy Coordinator assists patients who may qualify for assistance through Not for Profit Organizations and Manufacturer Programs. They are responsible for navigating the system to find resources that best fits the patient&rsquo;s needs, aid patients by explaining the process, assist in filling out applications and going over the documents that will be required to complete the application.</div>
<div></div><div><b>How You&rsquo;ll Do This</b></div>
<ul><li>Practice first call resolution to assist patients and families in securing financial assistance for pharmacy co-pays.</li>
<li>Maintain a working knowledge of health insurance and pharmacy benefit coverage, cancer diagnoses and drugs used in their treatment.</li>
<li>Support applications for nonprofit and manufacturer assistance programs.</li>
<li>Provide clear explanations of insurance benefits and co-pay structures.</li>
<li>Maintain accurate patient demographic and insurance data in CPR+.</li>
<li>Collaborate with pharmacy operations and cross-functional teams to ensure seamless service.</li>
</ul> <p></p><div><b>What You Bring</b></div>
<div><b>Required:</b></div>
<ul><li>High School Diploma or GED</li>
<li>1+ years of patient assistance or advocacy experience</li>
<li>Registration with Board of Pharmacy (as required by state law)</li>
<li>Strong communication, organizational, and customer service skills</li>
</ul><div><b>Preferred:</b></div>
<ul><li>Associate degree or Certified Pharmacy Technician (PTCB)</li>
<li>3+ years of patient assistance or advocacy experience</li>
<li>Specialty pharmacy experience</li>
</ul><p></p><div><b>Join a mission-driven team making a difference in the lives of cancer patients.</b></div>
<div></div><div><b>#Company Values: Teamwork, Respect, Integrity, Passion</b></div></div>

<div><div><div>This is an excellent opportunity for professional growth! As our organization continues to expand and our employees develop and promote within, we currently have <b>Full Time</b> positions available on our phone support team.</div>
<div></div><div>Our specialty pharmacy is located in <b>New Hyde Park, NY</b>. This is a <b>remote opportunity, </b><b>after</b><b> onsite training period.</b></div>
<div></div><div><b>Starting salary from $23.00 an hour and up</b><b> - w</b><b>e also offer $3.00/HR shift differential for WEEKEND schedules.</b></div>
<div><b>Sign-On Bonus: </b><b>$5,000 for employees starting before July 31, 2026.</b></div>
<div></div><div>We offer quarterly incentive bonuses as well as a $500 bonus for technicians to obtain their CPhT and/or CPhT-ADV credentials.</div>
<div></div><div>We offer a variety of benefits including:</div>
<ul><li>Medical; Dental; Vision</li>
<li>401k with a match</li>
<li>Paid Time Off and Paid Holidays</li>
<li>Tuition Reimbursement</li>
<li>Company paid benefits &ndash; life; and short and long-term disability</li>
<li>Paid Volunteer Day</li>
<li>Floating Holiday</li>
<li>Referral Incentive</li>
</ul>
<div></div><div>As a member of our Outbound Phone Support team, you will:</div>
<ul><li>Assist health care providers and patients by phone; answering questions and requests.</li>
<li>Communicate with patients and physician office staff to coordinate medication refill deliveries.</li>
<li>Work with Insurance companies regarding rejected claims and prior authorizations.</li>
<li>Serve as a primary contact for calls to patients and physicians.</li>
</ul>
<div></div><div>To be successful in this role, you will need:</div>
<ul><li>Good interpersonal skills</li>
<li>Excellent verbal, written and customer service skills</li>
<li>Ability to work independently, meet deadlines and be flexible</li>
<li>Good organizational skills and detail oriented</li>
<li>Knowledge of medical terminology (including sig codes and Roman numeral), brand and generic names of medications and general pharmacy terminology</li>
<li>Ability to perform tasks accurately and efficiently when inputting information</li>
<li>Licensed/registered pharmacy technician or as required by state law</li>
<li>Basic math and analytical skills</li>
<li>Intermediate typing/keyboarding skills</li>
</ul>
<div></div><div>Required education:</div>
<ul><li>High school or equivalent</li>
</ul><div>Required experience:</div>
<ul><li>Pharmacy Technician: 1+ years</li>
</ul><div>Required license or certification:</div>
<ul><li>Registered Pharmacy Technician</li>
</ul><div>Onco360, a closed-door specialty pharmacy, is seeking compassionate professionals who have an outstanding skillset in customer service. We are looking for certified pharmacy technicians who strive to go above and beyond for our patients and are confident speaking with patients and providers on the phone.</div>
</div><div></div><div><b>#OncoPhone1</b></div></div>

Certified Pharmacy Technician - Phone Support (Outbound)

<div><div>We are seeking a Pharmacy Adjudication Specialist for our Specialty Oncology pharmacy.</div>
<div><b>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.</b></div>
<div></div><div><b>Full-Time position may work remotely but MUST HAVE ACTIVE MISSOURI PHARMACY TECHNICIAN credentials from the State Board of Pharmacy.</b></div>
<div></div><div><b>Shift times between 8am and 8pm.</b></div>
<div></div><div>Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers.</div>
<div></div><div><b>Starting salary from $25.00 an hour and up</b></div>
<div><b>Sign-On Bonus: </b><b>$5,000 for employees starting before July 31, 2026.</b></div>
<div></div><div>We offer a variety of benefits including:</div>
<ul><li>Medical; Dental; Vision</li>
<li>401k with a match</li>
<li>Paid Time Off and Paid Holidays</li>
<li>Tuition Reimbursement</li>
<li>Company paid benefits &ndash; life; and short and long-term disability</li>
</ul><div><b>Pharmacy Adjudication </b><b>Specialist Major Responsibilities:</b></div>
<div>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</div>
<div></div><div>Pharmacy Adjudication Specialists at Onco360...</div>
<ul><li>Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests.</li>
<li>Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding active claims information..</li>
<li>Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information.</li>
<li>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.</li>
<li>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</li>
<li>Ensures copay cards are only applied to claims for eligible patients based on set criteria such as insurance type (Government beneficiaries not eligible)</li>
<li>Manages all funding related adjudications and works as a liaison to Onco360 Advocate team.</li>
<li>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.</li>
<li>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.</li>
<li>Documents and submit requests for Patient Refunds when appropriate.</li>
<li>Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws.</li>
<li>Contributes to team effort by accomplishing related tasks as needed and other duties as assigned.</li>
<li>Conducts job responsibilities in accordance with the standards set out in the Company&rsquo;s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.</li>
</ul><div>Pharmacy Adjudication Specialist Qualifications and Responsibilities...</div>
<div><ul><li>Education/Learning Experience
<ul><li>Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification, Pharmacy Claims Adjudication</li>
<li>Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician, Specialty pharmacy experience</li>
</ul></li></ul><ul><li>Work Experience
<ul><li>Required: 2+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience</li>
<li>Desired: 3+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience</li>
</ul></li></ul><ul><li>Skills/Knowledge
<ul><li>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</li>
<li>Desired: Knowledge of Foundation Funding, Specialty pharmacy experience</li>
</ul></li></ul><ul><li>Licenses/Certifications
<ul><li>Required: Pharmacy Technician License/Registration with Board of Pharmacy as required by state law</li>
</ul></li><li>Behavior Competencies
<ul><li>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</li></ul></li></ul></div></div>

Pharmacy Claims Adjudication Specialist

<div><div>We are seeking a Pharmacy Adjudication Specialist for our Specialty Oncology pharmacy.</div>
<div><b>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.</b></div>
<div></div><div><b>Full-Time position working out of the State of Indiana</b>.<b> This position may work remotely.</b></div>
<div></div><div><b>Shift times currently available: 9:00am- 5:30pm EST or 10:00am-6:30 pm EST</b></div>
<div></div><div>Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers.</div>
<div></div><div><b>Starting salary from $25.00 an hour and up</b></div>
<div><b>Sign-On Bonus: </b><b>$5,000 for employees starting before July 31, 2026.</b></div>
<div></div><div>We offer a variety of benefits including:</div>
<ul><li>Medical; Dental; Vision</li>
<li>401k with a match</li>
<li>Paid Time Off and Paid Holidays</li>
<li>Tuition Reimbursement</li>
<li>Company paid benefits &ndash; life; and short and long-term disability</li>
</ul><div><b>Pharmacy Adjudication </b><b>Specialist Major Responsibilities:</b></div>
<div>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</div>
<div></div><div>Pharmacy Adjudication Specialists at Onco360...</div>
<ul><li>Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests.</li>
<li>Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding active claims information..</li>
<li>Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information.</li>
<li>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.</li>
<li>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</li>
<li>Ensures copay cards are only applied to claims for eligible patients based on set criteria such as insurance type (Government beneficiaries not eligible)</li>
<li>Manages all funding related adjudications and works as a liaison to Onco360 Advocate team.</li>
<li>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.</li>
<li>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.</li>
<li>Documents and submit requests for Patient Refunds when appropriate.</li>
<li>Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws.</li>
<li>Contributes to team effort by accomplishing related tasks as needed and other duties as assigned.</li>
<li>Conducts job responsibilities in accordance with the standards set out in the Company&rsquo;s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.</li>
</ul><div>Pharmacy Adjudication Specialist Qualifications and Responsibilities...</div>
<div><ul><li>Education/Learning Experience
<ul><li>Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification, Pharmacy Claims Adjudication</li>
<li>Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician, Specialty pharmacy experience</li>
</ul></li></ul><ul><li>Work Experience
<ul><li>Required: 2+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience</li>
<li>Desired: 3+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience</li>
</ul></li></ul><ul><li>Skills/Knowledge
<ul><li>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</li>
<li>Desired: Knowledge of Foundation Funding, Specialty pharmacy experience</li>
</ul></li></ul><ul><li>Licenses/Certifications
<ul><li>Required: Pharmacy Technician License/Registration with Board of Pharmacy as required by state law</li>
</ul></li><li>Behavior Competencies
<ul><li>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</li></ul></li></ul></div></div>

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Onco360

About Company

Pharmacy Benefits Verification Specialist

Pharmacy Benefits Verification Specialist

Pharmacy Patient Advocacy Coordinator / Patient Assistance Programs

Pharmacy Patient Advocacy Coordinator / Patient Assistance Programs

Certified Pharmacy Technician - Phone Support (Outbound)

Pharmacy Claims Adjudication Specialist

Pharmacy Claims Adjudication Specialist