Pharmacy Prior Authorization Specialist

Onco360; Houston (TX); Hybrid; USD 47,000 - 57,000; Full time

Benefits offered by this job

Sign-on bonus

Remote work after training

Job summary

Onco360 Pharmacy in Houston, TX is hiring a Pharmacy Prior Authorization Specialist. This full-time role offers on-site work with remote capability after initial on-site training. Starting at $23.00/hr and up, with a $5,000 sign-on bonus for eligible hires.

The role focuses on obtaining pre-authorizations, resolving rejected claims, and coordinating with care teams to ensure patients receive necessary medications.

Qualifications

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

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.

Skills

Prior Authorization

Pharmacy terminology

HIPAA compliance

Documentation

Customer service

Education

High School Diploma or GED

Tools

CoverMyMeds

Job description

Position:Pharmacy Prior Authorization Specialist

Location:Houston, TX

Job Id:5615

# of Openings:1

Pharmacy Prior Authorization Specialist - Onco360 Pharmacy

Houston, TX | 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 aPharmacy Prior Authorization Specialistto join our dedicated team in Houston, TX. This is a full-time position ideal for candidates local to the area. Remote work possible after initial on-site training.

Why Join Us?

• A career with purpose: Help patients access life-saving medications.
• Supportive culture: We valueteamwork, 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