Pharmacy Prior Authorization Specialist

Onco360 • Houston, TX

1d

About The Position

Onco360 Pharmacy is seeking a full-time Pharmacy Prior Authorization Specialist in Houston, Texas. The role helps patients access medications requiring insurance pre-authorization by receiving prescriptions, resolving rejected claims, and completing third-party authorization requests. The position is intended for candidates local to the area; remote work may be possible after initial on-site training. The role supports patients with cancer and works with insurance carriers, physicians, pharmacists, and other departments.

Requirements

• High school diploma or GED.
• At least 1 year of pharmacy or prior authorization experience.
• 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, and commercial insurance; pharmacy test claims and NCPDP claim rejection resolution; coordination of benefits; NDC medication billing; and 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 when 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 third-party authorization requests.

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• 401(k) with a match
• Paid time off
• Paid holidays
• Tuition reimbursement
• Quarterly incentive bonus
• Paid volunteer day
• Referral incentive program
• Company-paid life insurance
• Short- and long-term disability
• $5,000 sign-on bonus for employees starting before December 28, 2026

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED