Pharmacy Prior Authorization Specialist
About The Position
Onco360 Pharmacy is hiring a full-time Pharmacy Prior Authorization Specialist working out of Ohio. The role may be performed remotely if the employee is licensed in Ohio. The schedule is Monday through Friday, 11:30 a.m. to 8:00 p.m. EST. Starting pay is $23.00 per hour and up; a $5,000 sign-on bonus is available to employees who start before December 28, 2026. The specialist helps ensure patients receive medications requiring prior authorization by receiving prescriptions, resolving rejected claims, and submitting necessary authorization requests to third parties. The role manages authorizations and appeals, collaborates with physicians, pharmacists, and other departments, handles sensitive information in compliance with HIPAA, documents authorization details accurately, and monitors authorizations for renewal.
Requirements
- High school diploma or GED.
- At least 1 year of pharmacy or prior authorization experience.
- Pharmacy Technician License/Registration with the 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, commercial insurance, pharmacy test claims and NCPDP claim rejection resolution, coordination of benefits, and NDC medication billing.
- Experience with CoverMyMeds.
Nice To Haves
- Associate degree or Certified Pharmacy Technician (PTCB).
- At least 3 years of experience in pharmacy or prior authorizations.
- Specialty pharmacy experience.
Responsibilities
- 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.
- Receive prescriptions, address and rectify rejected claims, and conduct necessary third-party authorization requests.
Benefits
- Medical, dental, and vision coverage.
- 401(k) with a match.
- Paid time off and paid holidays.
- Tuition reimbursement.
- Quarterly incentive bonus.
- Paid volunteer day.
- Referral incentive program.
- Company-paid life insurance.
- Short- and long-term disability coverage.
- $5,000 sign-on bonus for employees starting before December 28, 2026.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
