Pharmacy Prior Authorization Specialist

Onco360; Village of New Hyde Park (NY); Hybrid; USD 28,000 - 40,000; 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 Pharmacy in New Hyde Park, NY is seeking a Pharmacy Prior Authorization Specialist. This full-time role focuses on ensuring patients receive medications requiring insurer pre-authorizations.

Remote work is possible after initial on-site training. You will collaborate with physicians and pharmacists, maintain documentation, and monitor authorizations while upholding HIPAA standards.

Qualifications

• 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, and NCPDP claim rejection resolution.

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

NCPDP claim resolution

HIPAA compliance

Communication skills

Organizational skills

Customer service

CoverMyMeds

Education

High School Diploma or GED

Tools

CoverMyMeds

NCPDP

Job description

Position:Pharmacy Prior Authorization Specialist

Location: New Hyde Park, NY

Job Id:5646

# of Openings:1

Pharmacy Prior Authorization Specialist – Onco360 Pharmacy New Hyde Park, NY | Full-Time | Starting at $25.00/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 and rare disease patients.

Onco360 Pharmacy is seeking aPharmacy Prior Authorization Specialistto join our dedicated team in New Hyde Park, NY. 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

#Company Values: Teamwork, Respect, Integrity, Passion