Pharmacy Prior Authorization Specialist

Onco360; Louisville (KY); On-site; USD 26,139 - 37,229; Full time

Benefits offered by this job

Medical, Dental, Vision

401k with match

Paid Time Off

Tuition Reimbursement

Quarterly Incentive Bonus

Paid Volunteer Day

Referral Incentive Program

Life Insurance; Disability

Job summary

Onco360 Pharmacy in Louisville, KY is seeking a Pharmacy Prior Authorization Specialist to ensure patients receive required medications through timely pre-authorizations. This full-time role allows on-site work with remote possibilities after training.

The position requires 1+ year of pharmacy/Prior Authorization experience, strong communication, and knowledge of insurance processes, Medicare/Medicaid, and CoverMyMeds.

Qualifications

• High School Diploma or GED required.
• Experience with pharmacy or prior authorizations preferred.
• Knowledge of pharmacy terminology and insurance claims is required.

Responsibilities

• Manage prior authorization requests and appeals with insurance carriers.
• Collaborate with physicians, pharmacists, and other departments.
• Ensure HIPAA compliance while handling patient information.
• Maintain accurate documentation of authorization details.
• Proactively renew expiring authorizations.

Skills

Communication skills

Organizational skills

Customer service

Pharmacy terminology

Medicare/Medicaid knowledge

Education

High School Diploma or GED

Associate degree or PTCB certification

Tools

CoverMyMeds

Job description

Pharmacy Prior Authorization Specialist - Onco360 Pharmacy

Louisville, KY | Full-Time | Starting at $23.00/hr and up

Sign-On Bonus: $5,000 for employees starting before August 31, 2026!

Onco360 Pharmacy is seeking a Pharmacy Prior Authorization Specialist to join our dedicated team in Louisville, KY. 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 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