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Onco360

Pharmacy Prior Authorization Specialist

Posted 6 days ago
0-2 years experience
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AI Summary

The Pharmacy Prior Authorization Specialist manages prior authorization requests and appeals with insurance carriers to ensure patients receive necessary medications. They also collaborate with healthcare providers and maintain accurate documentation while ensuring HIPAA compliance.

Pharmacy Prior Authorization Specialist – Onco360 Pharmacy
Full-TimeStarting at $23.00/hr and up
Shift times currently available: 9:00am- 5:30pm EST or 9:30 - 6:00 pm EST
 
Full-Time position working out of the State of Connecticut. This position may work remotely
 
Sign-On Bonus: $5,000 for employees starting before October 31, 2026!
 
As our company continues to grow, we strive to hire new team members with a passion for making a difference in our patient's lives.
 

 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.
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

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
  • 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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