Pharmacy Prior Authorization Specialist

About Our Client:The organization operates in the pharmaceutical and oncology support sector, focusing on facilitating patient access to essential medications, particularly for cancer treatments. It addresses challenges patients face in obtaining prior authorizations for medications, thereby supporting timely and effective treatment delivery. The organization emphasizes a mission-driven approach to improve outcomes for cancer patients. About the Opportunity:The PHARMACY PRIOR AUTHORIZATION SPECIALIST is responsible for managing prior authorization requests to ensure patients receive prescribed medications that require insurance approval. This role plays a critical part in coordinating between insurance carriers, healthcare providers, and pharmacy teams to resolve claim rejections and maintain compliance. The position impacts patient care by facilitating access to necessary medications and supporting operational efficiency. 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.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, 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).Preferred: 3+ years of experience in pharmacy or prior authorizations.Preferred: Specialty pharmacy experience. Pay Range and Compensation Package:Starting at $23.00 per hour and up.Sign-On Bonus of $5,000 for employees starting before December 28, 2026. Benefits & Perks:Medical, dental, and vision insurance.401(k) plan with company 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 coverage. Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note:RemoteHunter is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.