Pharmacy Prior Authorization Specialist
About The Position
Pharmacy Prior Authorization Specialist – Onco360 Pharmacy Waltham, MA | Full-Time | Starting at $23.00/hr and up Join a mission-driven team making a difference in the lives of cancer and rare disease patients. Onco360 Pharmacy is seeking a Pharmacy Prior Authorization Specialist to join our dedicated team in Waltham, MA. This is a full-time position ideal for candidates local to the area. Remote work possible after initial on-site training. 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. 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.
Requirements
- 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
Nice To Haves
- Associate degree or Certified Pharmacy Technician (PTCB)
- 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.
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
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
