Pharmacy Prior Authorization Specialist

Onco360 Oncology Pharmacy; Waltham (MA); Hybrid; USD 32,000 - 39,000; Full time

Benefits offered by this job

Medical

Dental

Vision

401k with match

Paid Time Off & Holidays

Tuition Reimbursement

Quarterly Incentive Bonus

Paid Volunteer Day

Referral Incentive Program

Life Insurance

Disability

Job summary

Onco360 Pharmacy in Waltham, MA is seeking a Pharmacy Prior Authorization Specialist to ensure patients receive medications requiring pre-authorizations. This full-time role offers on-site training followed by possible remote work.

You will manage prior authorization requests with insurers, collaborate with physicians and pharmacists, and maintain HIPAA-compliant documentation. Starting pay is $23 per hour with a $5,000 sign-on bonus for eligible hires.

Qualifications

• 1+ years of pharmacy or prior authorization experience.
• Registration with Board of Pharmacy as required by state law.
• Knowledge of pharmacy terminology, insurance claims, Medicare/Medicaid, and CoverMyMeds.

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

Strong communication

Organizational skills

Customer service

Education

High School Diploma or GED

Associate degree or Certified Pharmacy Tech (PTCB)

Tools

CoverMyMeds

Job description

Pharmacy Prior Authorization Specialist - Onco360 Pharmacy Waltham, MA | Full-Time | Starting at $23.00/hr and up Sign-On Bonus: $5,000 for employees starting before September 30, 2026! 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.

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.

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