Pharmacy Prior Authorization Specialist

Onco360 Oncology Pharmacy; Waltham (MA); Hybrid; USD 26,139 - 37,229; Full time

Benefits offered by this job

Medical

Dental

Vision

401k with a match

Paid Time Off

Tuition Reimbursement

Quarterly Incentive Bonus

Paid Volunteer Day

Referral Incentive Program

Company Paid Life Insurance

Short/Long-Term Disability

Job summary

Onco360 Oncology Pharmacy is hiring a Pharmacy Prior Authorization Specialist in Waltham, MA. This full-time role involves ensuring that patients receive necessary medications by managing prior authorization requests. Ideal candidates will have a high school diploma and at least one year of pharmacy experience. Strong communication and organizational skills are essential. The position allows for remote work after initial training and offers various benefits, including medical, dental, and 401k with a match.

Qualifications

• 1+ year of pharmacy or prior authorization experience.
• Knowledge of pharmacy terminology and insurance claims.
• Registration with Board of Pharmacy as required by state law.

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

Communication skills

Organizational skills

Customer service skills

Detail-oriented

Self-motivated

Education

High School Diploma or GED

Associate degree or Certified Pharmacy Technician (PTCB)

Tools

CoverMyMeds

Job description

Pharmacy Prior Authorization Specialist – Onco360 Pharmacy

Waltham, MA | Full-Time | Starting at $23.00/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.

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+ year 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.