Pharmacy Claims Adjudication Specialist

Education and experience

• High school diploma or GED required
• Previous experience in pharmacy, medical billing, benefits verification, or pharmacy claims adjudication required
• Associate degree or equivalent 2-year technical program preferred
• Specialty pharmacy experience preferred
• 2+ years of experience in a pharmacy or healthcare setting, or pharmacy claims experience required
• 3+ years of experience in a pharmacy or healthcare setting, or pharmacy claims experience preferred

Skills and knowledge

• Pharmacy/NDC medication billing
• Pharmacy claims resolution
• PBM and medical contracts
• Knowledge of Medicare, Medicaid, and commercial insurance
• NCPDP claim rejection resolution
• Coordination of benefits
• Pharmacy terminology, including sig codes, Roman numerals, and brand/generic medication names
• Basic math and analytical skills
• Intermediate typing and keyboarding skills

Licenses and certifications

• Registration with the Board of Pharmacy as required by state law
• Certified Pharmacy Technician (PTCB) preferred

Behavioral competencies

• Independent worker
• Strong interpersonal skills
• Excellent verbal and written communication skills
• Ability to work independently and meet deadlines
• Flexible, detail-oriented, and well-organized

Benefits

• Medical, dental, and vision coverage
• 401(k) with company match
• Paid time off and paid holidays
• Tuition reimbursement
• Company-paid life insurance
• Company-paid short-term and long-term disability

Additional compensation

• Sign-on bonus of $5,000 for employees starting before September 30, 2026