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 professionals and maintain accurate documentation while ensuring HIPAA compliance.
Pharmacy Prior Authorization Specialist – Onco360 Pharmacy Full-Time | Starting 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 Vermont. This position may work remotely
Sign-On Bonus: $5,000 for employees starting before December 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
Pharmacy Technician License/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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