Pharmacy Prior Authorization Specialist

Onco360; Waltham (MA); On-site; USD 47,000 - 65,000; Full time

Benefits offered by this job

Medical insurance

401k with match

Paid time off

Tuition reimbursement

Quarterly incentive bonus

Volunteer day

Referral incentive

Life insurance

Disability insurance

Job summary

Onco360 Pharmacy is hiring a Pharmacy Prior Authorization Specialist in Waltham, MA. This full-time role offers a starting wage of $23.00/hour with a $5,000 sign-on bonus for joining before August 31, 2026.

Remote work may be possible after completing initial on-site training, making it suitable for local candidates and those open to hybrid work arrangements. You will manage prior authorizations, coordinate with physicians and pharmacies, and ensure HIPAA-compliant handling of patient

Qualifications

• Experience in pharmacy or prior authorization processes is required.
• Strong communication, organizational, and customer service skills are essential.
• Familiarity with pharmacy terminology and insurance claims is preferred.

Responsibilities

• Manage prior authorization requests and appeals with insurance carriers.
• Collaborate with physicians, pharmacists, and other departments to obtain approvals.
• Ensure HIPAA compliance and accurate documentation of authorizations.
• Monitor and renew expiring authorizations in a timely manner.

Skills

Communication

Organization

Customer service

Adaptability

Education

High School Diploma or GED

Board of Pharmacy registration

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 August 31, 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.

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

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