Pharmacy Prior Authorization Specialist

Onco360Onco360Burlington, Vermont, United States
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Posted

9/23/2026

Employment

Full time

Range

$23 - $23/hr

Work style

Remote OK

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AI summary

Core responsibilities

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.

Requirements overview

Candidates must have a High School Diploma or GED and at least one year of pharmacy or prior authorization experience. A valid Pharmacy Technician License or registration is required as per state law.

Key skills

Prior authorizationPharmacy terminologyInsurance claimsMedicareMedicaidCommercial insuranceNCPDP claim rejection resolutionCoordination of benefitsNDC medication billingCoverMyMedsHIPAA complianceCommunication skillsOrganizational skillsCustomer serviceDetail-orientedPharmacy technician

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Education requirements

high schoolassociate degree

About Onco360

Industry

Pharmaceutical Manufacturing

Employees

759

Type

Public Company

Size

501-1,000 employees

Onco360 is recognized as one of the nation's leading independent specialty pharmacies dedicated exclusively to oncology and rare disease patients. Through our comprehensive patient support programs, clinical expertise, and commitment to personalized care, we play a critical role in helping patients access, manage, and adhere to complex therapies while navigating the challenges associated with cancer treatment. We focus on delivering specialized pharmacy services and improving the patient experience positioning us at the forefront of healthcare innovation. By collaborating with healthcare providers, pharmaceutical manufacturers, and patient communities, Onco360 is helping bridge the gap between therapeutic innovation and real-world patient outcomes. In its focus to bring together the stakeholders involved in the cancer treatment process, Onco360 is advancing the continuum of oncology pharmaceutical care through patient advocacy, dispensing excellence, and the clinical experience and expertise that comes from its focus in oncology. Onco360 is headquartered in Louisville, KY and dispenses nationally through its network URAC, ACHC, NAPB, and JCAHO accredited Oncology Pharmacies.

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Job categories

HealthcareCustomer Service & SupportAdministrative

Description

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.    

Requirements

  • Prior authorization
  • Pharmacy terminology
  • Insurance claims
  • Medicare
  • Medicaid
  • Commercial insurance
  • NCPDP claim rejection resolution
  • Coordination of benefits
  • NDC medication billing
  • CoverMyMeds
  • HIPAA compliance
  • Communication skills
  • Organizational skills
  • Customer service
  • Detail-oriented
  • Pharmacy technician

Benefits

  • Medical
  • Dental
  • Vision
  • 401k with a match
  • Paid Time Off
  • Paid Holidays
  • Tuition Reimbursement
  • Quarterly Incentive Bonus
  • Paid Volunteer Day
  • Referral Incentive Program
  • Company Paid Life Insurance
  • Short-Term Disability
  • Long-Term Disability
  • Sign-On Bonus

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