Pharmacy Prior Authorization Specialist

Xtalks; Buffalo (NY); Hybrid; USD 48,000 - 56,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401k with match

Paid Time Off and Paid Holidays

Tuition Reimbursement

Quarterly Incentive Bonus

Paid Volunteer Day

Referral Incentive Program

Company Paid Life Insurance; and Short

Job summary

Onco360 Pharmacy in Buffalo, NY is seeking a Pharmacy Prior Authorization Specialist to join our dedicated team. This full-time role starts at $23.00 per hour, with remote work possible after on-site training and a $5,000 sign-on bonus for new hires meeting the deadline.

You will collaborate with physicians and pharmacists to obtain pre-authorizations, manage appeals, ensure HIPAA compliance, and maintain precise documentation to help patients access life-saving medications.

Qualifications

• High School Diploma or GED required.
• 1+ years of pharmacy or prior authorization experience.
• Registration with Board of Pharmacy as required by state law.
• Knowledge of pharmacy terminology, Medicare/Medicaid, and insurance claims.
• Experience with CoverMyMeds preferred.

Responsibilities

• Process prior authorization requests with insurance carriers.
• Address and rectify rejected claims and obtain authorizations.
• Collaborate with physicians, pharmacists, and other departments.
• Ensure HIPAA compliant handling and accurate documentation.
• Proactively monitor and renew expiring authorizations.

Skills

Strong communication

Organizational skills

Customer service

HIPAA compliance

Adaptability

Education

High School Diploma or GED

Associate degree or PTCB certification

Tools

CoverMyMeds

Job description

Pharmacy Prior Authorization Specialist - Onco360 Pharmacy

Buffalo, NY | Full-Time | Starting at $23.00/hr and up

Sign-On Bonus: $5,000 for employees starting before October 31, 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 Buffalo, NY. This is a full-time position ideal for candidates local to the area. Remote work possible after initial on-site training.

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

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.

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.

Required

What You Bring

• 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