Pharmacy Prior Authorization Specialist

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
• 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:
• A 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:
• An associate degree or Certified Pharmacy Technician (PTCB)
• 3+ years of experience in pharmacy or prior authorizations
• Specialty pharmacy experience

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.

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