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Onco360

Pharmacy Prior Authorization Specialist

Posted 19 hours ago
0-2 years experience
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AI Summary

The Pharmacy Prior Authorization Specialist manages prior authorization requests and appeals while collaborating with healthcare providers to ensure patients receive necessary medications. They are responsible for resolving rejected insurance claims and maintaining accurate documentation in compliance with HIPAA regulations.

Pharmacy Prior Authorization Specialist – Onco360 Pharmacy
Buffalo, NY |  Full-Time |  Starting at $23.00/hr and up
 
Sign-On Bonus: $5,000 for employees starting before October 31, 2026!
 
Join a mission-driven team making a difference in the lives of cancer patients.
 
Onco360 Pharmacy is seeking a Pharmacy Prior Authorization Specialist to join our dedicated team in Buffalo, NY. This is a full-time position ideal for candidates local to the area. Remote work possible after initial on-site training.
 
Company Benefits
  • Medical; Dental; Vision
  • 401k with a match
  • Paid Time Off and Paid Holidays
  • Tuition Reimbursement
  • Quarterly Incentive Bonus
  • Paid Volunteer Day
  • Referral Incentive Program
  • Company Paid Life Insurance; and Short/Long-Term Disability

 Why Join Us?
  • A career with purpose: Help patients access life-saving medications.
  • Supportive culture: We value teamwork, respect, integrity, and passion.
  • Growth opportunities: We invest in your professional and personal development.

What You’ll Do
 
The Pharmacy Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations from insurance carriers by receiving prescriptions, addressing and rectifying rejected claims and conducting necessary third party authorization requests.
 
How You’ll Do This
  • Manage prior authorization requests and appeals with insurance carriers.
  • Collaborate with physicians, pharmacists, and other departments.
  • Ensure HIPAA compliance while handling sensitive patient information.
  • Maintain accurate documentation of authorization details.
  • Proactively monitor and renew expiring authorizations.

What You Bring
 
Required:
  • High School Diploma or GED
  • 1+ years of pharmacy or prior authorization experience
  • Registration with Board of Pharmacy (as required by state law)
  • Strong communication, organizational, and customer service skills
  • Self-motivated, organized, detail-oriented, and adaptable to changing priorities
  • Knowledge of pharmacy terminology, pharmacy insurance claims, Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, experience with CoverMyMeds
Preferred:
  • Associate degree or Certified Pharmacy Technician (PTCB)
  • 3+ years of experience in pharmacy or prior authorizations
  • Specialty pharmacy experience

Ready to make a meaningful impact? Apply today and help us better the lives of those battling cancer.
 

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