Pharmacy Prior Authorization Specialist

Socket.dev; Houston (TX); Hybrid; USD 32,000 - 43,000; Full time

Benefits offered by this job

Medical; Dental; Vision

401k with match

PTO 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 Houston, TX is seeking a Pharmacy Prior Authorization Specialist. The role ensures patients receive medications requiring pre-authorizations by coordinating with insurance carriers and healthcare providers. On-site training precedes any remote work.

The position offers a mission-driven environment with a comprehensive benefits package and a potential sign-on bonus for eligible hires.

Qualifications

• High School Diploma or GED required.
• 1+ years of pharmacy or prior authorization experience.
• Board of Pharmacy registration 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, insurance claims (Medicare/Medicaid/commercial), and related billing concepts.

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

HIPAA compliance

Pharmacy terminology

Customer service

Communication skills

Self-motivated

Education

High School Diploma or GED

Tools

CoverMyMeds

NCPDP claims

Job description

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 August 31, 2026!

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

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

• 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 #IH