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:
• A high school diploma or GED.
• One to two years 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 claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, experience with CoverMyMeds.
• PREFERRED:
• An associate degree or Certified Pharmacy Technician (PTCB).
• Three to five years of experience in pharmacy or prior authorizations.
• Specialty pharmacy experience.

Company Benefits

• Medical;
• Dental;
• Vision;
• 401(k) 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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