Pharmacy Prior Authorization Specialist

What You’ll Do

• 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, 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

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