Pharmacy Benefit Verification Specialist

Onco360•Orlando, FL

1d•$24•Remote

About The Position

Onco360 Pharmacy is hiring Pharmacy Benefit Verification Specialists for its specialty oncology pharmacy. The role investigates, reviews, and loads accurate patient medical and pharmacy insurance coverage; assigns coordination of benefits; runs test claims to obtain valid insurance responses; identifies authorization requirements for medication coverage; and enrolls eligible patients in copay card assistance programs. Specialists document benefits accurately for prescription orders and help ensure patients receive responsive support. This is a full-time position that may be performed remotely, but requires active Florida Pharmacy Technician credentials from the State Board of Pharmacy. Shift times fall between 8 a.m. and 8 p.m. Starting pay is $24 per hour and up. The posting also offers a $5,000 sign-on bonus for employees starting before December 31, 2026, and quarterly incentive bonuses. Onco360 is a closed-door specialty pharmacy focused on patients undergoing cancer treatment. The company seeks specialists who are passionate about helping others and who strive to meet and exceed patients’ needs.

Requirements

High school diploma or GED.
At least 1 year of pharmacy or benefit verification experience.
Pharmacy Technician License/Registration with the Board of Pharmacy, as required by state law; this position specifically requires active Florida Pharmacy Technician credentials from the State Board of Pharmacy.
Knowledge of pharmacy insurance and benefit verification, PBM and medical contracts, Medicare, Medicaid, and commercial insurance.
Knowledge of pharmacy test claims and NCPDP claim-rejection resolution, coordination of benefits, and NDC medication billing.
Pharmacy or healthcare-related knowledge, including pharmacy terminology such as sig codes and Roman numerals, and brand and generic medication names.
Basic math and analytical skills and intermediate typing/keyboarding skills.
Ability to work independently, with good interpersonal skills, excellent verbal and written communication, efficiency in meeting deadlines, flexibility, attention to detail, and strong time-management skills.

Nice To Haves

Associate degree or equivalent program from a two-year program or technical school.
Certified Pharmacy Technician (PTCB).
Specialty pharmacy experience.
At least 3 years of pharmacy or benefit verification experience.

Responsibilities

Use first-call resolution to assist healthcare providers and patients with pharmacy needs, questions, and requests.
Provide thorough, accurate, and timely benefit-information responses to pharmacy operations, providers, and patients.
Ensure complete and accurate patient setup in the CPR+ system, including demographic and insurance information.
Verify pharmacy and medical benefits using electronic resources and E1 check, and load primary, secondary, tertiary, and other applicable insurance coverage to patient profiles.
Run test claims at each licensed pharmacy site to obtain a valid claim response and determine optimal reimbursement; document benefit-review outcomes in CPR+ and ensure orders are assigned to the appropriate dispensing pharmacy.
Facilitate requests for medical authorizations, LOAs, and TOAs for applicable commercial, Medicaid, Medicare, or facility medication claims.
Maintain a safe and clean pharmacy by complying with procedures, rules, regulations, and laws concerning professional practice and patient confidentiality.
Accomplish related tasks and other duties as assigned.
Perform job responsibilities in accordance with the Company’s Code of Business Conduct and Ethics, policies and procedures, Corporate Compliance Agreement, applicable federal and state laws, and professional standards.