Pharmacy Prior Authorization Specialist

About the role

The Pharmacy Prior Authorization Specialist ensures patients receive medications that require pre‑authorizations from insurance carriers. This full‑time position works out of Connecticut and may be performed remotely. The role involves receiving prescriptions, addressing and rectifying rejected claims, and conducting necessary third‑party authorization requests.

Responsibilities

• 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.

Requirements

• High School Diploma or GED.
• 1+ years of pharmacy or prior authorization experience.
• Strong communication, organizational, and customer service skills.
• Self‑motivated, detail‑oriented, and adaptable to changing priorities.
• Knowledge of pharmacy terminology, pharmacy insurance claims, Medicare, Medicaid, commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, and experience with CoverMyMeds.

Preferred Qualifications

• Associate degree or Certified Pharmacy Technician (PTCB) certification.
• 3+ years of experience in pharmacy or prior authorizations.
• Specialty pharmacy experience.

Benefits

• Medical, Dental, and Vision coverage.
• 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; Short‑Term and Long‑Term Disability.

Pay

Starting at $23.00/hr and up. Sign‑On Bonus: $5,000 for employees starting before October 31, 2026.

Schedule

Full‑Time. Shift times currently available: 9:00 am – 5:30 pm EST or 9:30 am – 6:00 pm EST. Position may be remote, working out of Connecticut.