Pharmacy Prior Authorization Specialist

Onco360 Oncology Pharmacy; Village of New Hyde Park (NY); On-site; USD 28,413 - 40,467; Full time

Benefits offered by this job

401k with a 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

A healthcare provider specializing in oncology is seeking a Pharmacy Prior Authorization Specialist for their New Hyde Park location. This full-time position involves managing medication authorizations, collaborating with healthcare professionals, and ensuring compliance with relevant regulations. Candidates should possess strong communication, organization, and customer service skills, alongside a high school diploma or GED. Experience in pharmacy or prior authorizations is required, making this an ideal role for those looking to make a meaningful impact in the lives of cancer patients.

Qualifications

• 1+ years of pharmacy or prior authorization experience.
• Registration with Board of Pharmacy (state law required).
• Knowledge of pharmacy terminology, and insurance claims.

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.

Skills

Strong communication skills

Organizational skills

Customer service skills

Detail-oriented

Adaptability

Education

High School Diploma or GED

Tools

CoverMyMeds

Job description

Position: Pharmacy Prior Authorization Specialist

Location: New Hyde Park, NY

Job Id: 4669

# of Openings: 1

Pharmacy Prior Authorization Specialist – Onco360 Pharmacy
New Hyde Park, NY | Full-Time | Starting at $25.00/hr and up

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

Onco360 Pharmacy is seeking a Pharmacy Prior Authorization Specialist to join our dedicated team in Waltham, MA. This is a full-time position ideal for candidates local to the area. Remote work possible after initial on-site training.

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

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.

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

Ready to make a meaningful impact? Apply today and help us better the lives of those battling cancer.

#Company Values: Teamwork, Respect, Integrity, Passion