AffirmedRx, PBC

PBM Claims Adjudication Specialist

AffirmedRx, PBC · Remote

Posted 20 days ago

or apply directly on AffirmedRx, PBC's site. We never take the application ourselves.

Is this posting real?

This role has been open
20 days
AffirmedRx, PBC's roles stay open a median of 21 days
Reposted
No
Salary listed
No
0% of AffirmedRx, PBC's roles list one
Ghost-job risk at AffirmedRx, PBC
moderate
3 stale, 0 reposted of 11 open
Hiring momentum
16 roles opened in the last 90 days
↑ up vs. the prior 90 days
Last confirmed on the employer's board
2026-09-17

Measured from postings appearing on and disappearing from AffirmedRx, PBC's own greenhouse board since 2026-08-03. Full hiring picture for AffirmedRx, PBC.

About this role

The PBM Claims Adjudication Specialist at AffirmedRx is responsible for developing and maintaining client eligibility and accumulator files to ensure data accuracy. This role involves hands-on PBM claims adjudication, coding automation for file processing, and managing secure file transmissions via SFTP. The specialist will also troubleshoot data discrepancies and collaborate with team members to resolve complex client issues.

Our read on this posting2.8out of 5
benefits
1/5
freshness
4/5
career value
4/5
role clarity
5/5
pay transparency
0/5

Scored from the posting itself — how clearly the role is described, how much it says about pay and benefits, and how recently it was listed. Not a judgement of AffirmedRx, PBC as an employer.

What you need

  • Bachelor’s degree in a related field, or equivalent experience
  • Deep, hands-on experience with PBM claims adjudication
  • 7+ years of direct PBM experience building and maintaining client eligibility files and accumulator files
  • Strong knowledge of NCPDP standards, claims processing rules, and benefit design as they relate to file build and testing
  • Experience with SFTP setup, configuration, and management for secure client file transmission
  • Excellent troubleshooting and problem-solving skills

Nice to have

  • Experience working with the RxSense platform

What you get

  • Competitive compensation, including health, dental, vision and other benefits

Worth weighing

  • Remote employees must maintain a professional work environment free of distractions
  • No salary listed

Summarised from AffirmedRx, PBC's posting. Read the full original.

Listed by AffirmedRx, PBC on their greenhouse job board, last confirmed open on 2026-09-17. PitchMeAI is not the employer.

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