Pharmacy Benefit Verification Specialist

Onco360•Scottsdale, AZ

About The Position

Onco360 Pharmacy is hiring a full-time Pharmacy Benefit Verification Specialist for its Scottsdale, Arizona pharmacy. The position may be performed remotely, but requires active Arizona Pharmacy Technician credentials from the State Board of Pharmacy. The schedule is Monday through Friday, with shift hours falling between 8 a.m. and 8 p.m. Starting pay is $24 per hour and up, with a $5,000 sign-on bonus for employees who start before December 31, 2026, and quarterly incentive bonuses. The specialist investigates, reviews, and loads accurate patient medical and pharmacy insurance coverage; coordinates benefits; runs test claims to obtain valid insurance responses; identifies authorization requirements; and enrolls eligible patients in copay card assistance programs. The specialist documents benefits accurately for prescription orders and supports patients, providers, and pharmacy operations. Onco360 is a closed-door specialty pharmacy focused on patients undergoing cancer treatment.

Requirements

Active Arizona Pharmacy Technician credentials from the State Board of Pharmacy.
High school diploma or GED.
Previous experience in pharmacy, medical billing, or benefits verification.
At least 1 year of pharmacy or benefit verification experience.
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 and excellent verbal and written communication skills.
Ability to work efficiently to meet deadlines and be flexible, with 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 help healthcare providers and patients with pharmacy needs, questions, and requests.
Provide thorough, accurate, and timely responses to pharmacy operations, providers, and patients regarding benefit information.
Set up patients accurately 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 medical insurance coverage to patient profiles.
Run test claims at each licensed pharmacy site to obtain valid claim responses and determine optimal reimbursement; document the review 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 following procedures, rules, regulations, and professional practice and patient confidentiality laws.
Complete related tasks and other duties as assigned.
Conduct 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.