Pharmacy Prior Authorization Specialist

Onco360; Town of Vermont (WI); Hybrid; USD 56,019,000 - 75,790,000; Full time

Benefits offered by this job

401k with match

Paid Time Off and Paid Holidays

Tuition Reimbursement

Quarterly Incentive Bonus

Referral Incentive Program

Company Paid Life Insurance

Short/Long-Term Disability

Job summary

Onco360 is seeking a Pharmacy Prior Authorization Specialist to join our Burlington, VT team. This full-time role may be remote, with shift options in EST hours and a starting pay of $23.00 per hour. A $5,000 sign-on bonus is offered for qualifying new hires before December 31, 2026.

You will manage prior authorization requests, coordinate with care teams, and ensure compliance with HIPAA while keeping precise authorization records and monitoring renewals.

Qualifications

• 1+ years of pharmacy or prior authorization experience.
• Pharmacy Technician License/Registration required by state law.
• Knowledge of Medicare, Medicaid and commercial insurance.
• NCPDP claim rejection resolution and coordination of benefits.

Responsibilities

• Process and manage prior authorization requests.
• Collaborate with physicians, pharmacists, and departments.
• Maintain HIPAA compliance and protect patient information.
• Monitor and renew expiring authorizations.
• Resolve rejected claims with insurers.

Skills

Pharmacy experience

Prior authorization

Communication skills

Organizational skills

Customer service

HIPAA compliance

Education

High School Diploma or GED

Tools

CoverMyMeds

Job description

Position:Pharmacy Prior Authorization Specialist

Location: Burlington, VT

Job Id:5766

# of Openings:1

Pharmacy Prior Authorization Specialist – Onco360 Pharmacy
Full-Time | Starting at $23.00/hr and up

Shift times currently available: 9:00am- 5:30pm EST or 9:30 - 6:00 pm EST

Full-Time position working out of the State of Vermont. This position may work remotely

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

As our company continues to grow, we strive to hire new team members with a passion for making a difference in our patient's lives.

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
• Pharmacy Technician License/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