Pharmacy Benefit Verification Specialist

Position Overview Onco360 Pharmacy is looking for Pharmacy Benefit Verification Specialists for our Specialty Oncology Pharmacy. You will work full-time, may work remotely, and must have active Missouri Pharmacy Technician credentials from the State Board of Pharmacy. Shift times are between 8 am and 8 pm. Compensation & Benefits Starting salary at $24 /hr and up Sign‑On Bonus: $5,000 for employees starting before July 31 , 2026 Quarterly incentive bonuses Medical, Dental & Vision insurance 401(k) with match Paid Time Off and Paid Holidays Tuition Reimbursement Paid Volunteer Day Floating Holiday Referral Incentive Paid Life, and short & long‑term disability insurance Role Summary The Benefit Verification Specialist investigates, reviews, and loads accurate patient insurances, including medical and pharmacy coverage, assigns coordination of benefits, runs test claims to obtain a valid insurance response on patient medications, investigates and identifies authorization requirements needed to obtain medication coverage, and enrolls eligible patients in copay card assistance programs. They ensure accurate benefit documentation for all prescription orders. Major Responsibilities Practice first call resolution to help healthcare providers and patients with pharmacy needs, answering questions and requests. Provide thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding benefit information. Ensure complete and accurate patient setup in CPR+ system including demographic and insurance information. Perform 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 order is assigned to the appropriate dispensing pharmacy. Facilitate process for requesting 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, and regulations and compliance with professional practice and patient confidentiality laws. Contribute to team effort by accomplishing related tasks as needed and other duties as assigned. Conduct 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. 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 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, 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 communication skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail‑oriented, great time‑management skills. EEO Statement Onco360 Pharmacy is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. #J-18808-Ljbffr Onco360 Oncology Pharmacy