Pharmacy Prior Authorization Specialist

Onco360 Oncology Pharmacy; Albuquerque (NM); Hybrid; USD 26,000 - 37,000; Full time

Benefits offered by this job

Medical, Dental, Vision

401k with match

Paid Time Off and Holidays

Tuition Reimbursement

Quarterly Incentive Bonus

Paid Volunteer Day

Referral Incentive Program

Life Insurance; Disability

Job summary

Onco360 Pharmacy in Albuquerque, NM is hiring a Pharmacy Prior Authorization Specialist to join a mission-driven team. This full-time role may include remote work if licensed in New Mexico.

You will manage prior authorizations with insurance carriers, collaborate with prescribers and pharmacists, ensure HIPAA compliance, and maintain accurate records.

Requirements include a high school diploma or GED, 1+ year of pharmacy or prior authorization experience, and state board registration.

Qualifications

• 1+ years of pharmacy or prior authorization experience.
• Knowledge of Medicare, Medicaid, and commercial insurance.
• Registration with Board of Pharmacy as required by state law.
• Strong communication and organizational skills.
• Ability to manage prior authorization requests and renewals.

Responsibilities

• Manage prior authorization requests and appeals with carriers.
• Collaborate with physicians, pharmacists, and staff to resolve denials.
• Ensure HIPAA-compliant handling of patient information.
• Maintain accurate authorization documentation.
• Proactively monitor expiring authorizations.

Skills

Prior authorization

Pharmacy experience

Communication skills

HIPAA compliance

Insurance claims knowledge

NCPDP claims knowledge

Coordination of benefits

Education

High School Diploma or GED

Associate degree or PTCB certification

Tools

CoverMyMeds

Job description

Pharmacy Prior Authorization Specialist – Onco360 Pharmacy

Albuquerque, NM | Full-Time | Starting at $23.00/hr and up

Sign-On Bonus: $5,000 for employees starting before September 30, 2026!

Join a mission-driven team making a difference in the lives of cancer patients.

Onco360 Pharmacy is seeking a Pharmacy Prior Authorization Specialist to join our dedicated team in the State of New Mexico. This is a full-time position. Remote work if licensed in State of New Mexico.

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.

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

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:

• 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 Values: Teamwork, Respect, Integrity, Passion