Pharmacy Prior Authorization Specialist

Onco360; Albuquerque (NM); On-site; USD 56,019,000 - 75,790,000; Full time

Benefits offered by this job

401k with a match

Paid Time Off and Paid Holidays

Tuition Reimbursement

Quarterly Incentive Bonus

Referral Incentive Program

Company Paid Life Insurance; and Short

Long-Term Disability

Job summary

Onco360 in Albuquerque, NM is seeking a Pharmacy Prior Authorization Specialist for a full-time role. Starting at $23.00/hr and up, with a $5,000 sign-on bonus for hires before 11/30/2026, you will manage pre-authorizations to ensure patients receive prescribed medications.

Collaborate with physicians and pharmacists, navigate insurance nuances, and maintain precise documentation while upholding HIPAA standards in a fast-paced environment.

Qualifications

• Required: High School Diploma or GED.
• 1+ years in pharmacy or prior authorization experience.
• Board of Pharmacy registration as required by state law.
• Strong communication, organizational, and customer service skills.

Responsibilities

• Process prior authorization requests and appeals with insurers.
• Collaborate with physicians, pharmacists, and departments.
• Maintain HIPAA-compliant handling of patient information.
• Document authorization details accurately and timely.
• Monitor and renew expiring authorizations proactively.

Skills

Communication skills

Organizational skills

Customer service

Detail oriented

Adaptable to priorities

Team collaboration

Education

High School Diploma or GED

Tools

CoverMyMeds

Job description

Position: Pharmacy Prior Authorization Specialist

Location: Albuquerque, NM

Job Id: 5840

# of Openings: 1

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 November 30, 2026!

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

• 401k with a match


• Paid Time Off and Paid Holidays


• Tuition Reimbursement


• Quarterly Incentive Bonus


• 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:

• 3+ years of experience in pharmacy or prior authorizations


• Specialty pharmacy experience