Pharmacy Prior Authorization Specialist at Onco360

Burlington, Vermont, United States -

Full Time

Start Date

Immediate

Expiry Date

18 Sep, 26

Salary

23.0

Posted On

20 Jun, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Prior Authorization, Insurance Claims Resolution, HIPAA Compliance, Pharmacy Terminology, Medicare, Medicaid, Commercial Insurance, NCPDP Claim Resolution, Coordination Of Benefits, NDC Medication Billing, CoverMyMeds, Customer Service, Organization, Communication, Specialty Pharmacy

Industry

Pharmaceutical Manufacturing

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 July 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.

Responsibilities

Manage prior authorization requests and appeals with insurance carriers to ensure patients receive necessary medications. Collaborate with healthcare providers and maintain accurate documentation while ensuring HIPAA compliance.