Prior Authorization Pharmacy Specialist I

Florida Cancer Specialists & Research Institute, LLC; Florida; Hybrid; USD 28,000 - 39,000; Full time

Benefits offered by this job

Medical coverage

Vision insurance

Dental insurance

401(k) matching

Tuition reimbursement

PTO

Job summary

Florida Cancer Specialists & Research Institute, LLC is seeking a Prior Authorization Specialist to manage prior authorizations and appeals for oral oncology and supportive medications. You will interact with patients, caregivers, and healthcare providers to resolve prescription inquiries and support timely patient care.

The role requires Florida Pharmacy Technician licensure, National certification, and PACS certification preferred.

Qualifications

• High School diploma or GED required.
• Active Registered Florida Pharmacy Technician license and state of residence required.
• Active National Pharmacy Technician Certification required.
• PACS certification preferred.

Responsibilities

• Demonstrates effective communication with internal and external parties.
• Performs clinical reviews of patient charts to complete prior authorizations.
• Process appeals for prior authorization denials with documentation and letters of medical necessity.
• Obtain prior authorization approvals via online sites (Eviti, New Century Health, Cover My Meds) and via fax/phone.
• Interpret or adjust data as needed to support prior authorizations.
• Escalate complex clinical concerns to the appropriate clinician for first-call resolution.
• Adhere to accreditation standards and privacy laws; follow policies and procedures.
• Participate in CQI to identify and report quality events.
• Support pharmacy staff and health care professionals in prescription processing.

Skills

Analysis & Critical Thinking

Interpersonal skills

Verbal & written comms

Time management

Cross-functional collaboration

Education

High school diploma or GED

Active Florida Pharmacy Technician license

Active National Pharmacy Technician Certification

PACS certification preferred

Tools

Eviti

New Century Health

Cover My Meds

Job description

Date Posted: 2026-11-03 Country: United States of America Location: Florida - Remote

WHY JOIN FCS

At Florida Cancer Specialists & Research Institute, we believe our people are our strength and we invest in them. In addition to having a positive impact on the people and communities we serve, associates benefit from significant professional opportunities, career advancement, training and competitive wages. Offering competitive salaries and comprehensive benefits packages to include tuition reimbursement, 401-K match, pet and legal insurance.

A LITTLE BIT ABOUT FCS

Since 1984, Florida Cancer Specialists & Research Institute & Research Institute (FCS) has built a national reputation for excellence. With over 250 physicians, 220 nurse practitioners and physician assistants and nearly 100 locations in our network. Utilizing innovative clinical research, cutting-edge technologies, and advanced treatments, we are committed to providing world‑class cancer care. We are recognized by the American Society of Clinical Oncology (ASCO) with a national Clinical Trials Participation Award, FCS offers patients access to more clinical trials than any private oncology practice in Florida. Our patients have access to ground‑breaking therapies, in a community setting, and may participate in national clinical research studies of drugs and treatment protocols. In the past five years, the majority of new cancer drugs approved for use in the U.S. were studied in clinical trials with FCS participation prior to approval. Through our partnership with Sarah Cannon, we are one of the largest clinical research organizations in the United States. Often, FCS leads the nation in initiating research studies and offering ground‑breaking new therapies to patients. Come join us today!

Seeking Florida resident candidates Registered Pharmacy Technician license required

Summary

The Prior Authorization Specialist is responsible for performing prior authorizations and appeals for oral oncology and supportive medications as an extension of the FCS medical practice. The Prior Authorization Specialist will interact with patients, caregivers, and healthcare providers regarding inquiries for prescription status. The specialist will assist the pharmacy staff and other health care professionals in supporting prescription processing to ensure prompt service and quality patient care.

PRIMARY TASKS AND RESPONSIBILITIES

• Demonstrates effective communication skills and premier customer service to successfully interact with all levels of internal and external parties to convey information correctly.
• Performs clinical reviews of patients’ charts using appropriate criteria to complete prior authorizations.
• Process appeals for prior authorization denials according to specific insurance plan requirements, provides documentation and composing a letter of medical necessity as appropriate.
• Obtain prior authorization approvals utilizing online authorization sites (ex: Eviti, New Century Health, Cover My Meds) and prior authorizations via fax and phone.
• May require interpretation or clinical data deviation from standard procedures.
• Escalate complex clinical concerns to the appropriate clinician with a goal of first call resolution.
• Comply with all accreditation standards, federal and state laws and regulations pertaining to patient privacy, patient’s rights, personnel law, safety, labor, and employment law.
• Adhere to Company and departmental policies and procedures, including IT, HR, and compliance policies and procedures and Disaster Recovery Plan.
• Participate in the pharmacy’s Continuous Quality Improvement (CQI) program by identifying and reporting quality related events.
• Additional tasks as needed to support the team and FCS.

EDUCATION/CERTIFICATIONS & LICENSES

A high school diploma or GED Required

Active Registered Florida Pharmacy Technician license and state of residence is required.

Active National Pharmacy Technician Certification is required.

Prior Authorization Certified Specialist (PACS) certification preferred.

EXPERIENCE

Pharmacy benefit prior authorization experience preferred.

Minimum three (3) years’ experience working in a health care or customer service‑related field, preferably pharmacy or call center required.

Hematology/oncology experience preferred.

CORE COMPETENCIES, KNOWLEDGE/SKILLS/ABILITIES

• Analysis & Critical Thinking
• Strong interpersonal skills to include effective verbal and written communication
• Solid time management with the ability to prioritize multiple tasks
• Ability to collaborate across various levels of management, departments and teams
• Comfortable negotiating problems and exploring solutions with physician population

VALUES

• Patient First – Keeping the patient at the center of everything we do
• Accountability – Taking responsibility for our actions
• Commitment & Care – Upholding FCS vision through every action
• Team – Working together, one team, one mission

EXPECTATIONS FOR ALL EMPLOYEES

Every FCS employee is expected to regularly conduct themselves in a professional and respectful manner, to comply with all labor laws, workplace policy and workplace practices. Employees are expected to bring issues of any forms of workplace harassment, discrimination, or other potential improprieties to the attention of their management or the human resources department.

#LI-DL1 #FCS-RX

SCREENINGS – Background and drug screens

Safeguarding our patients and each other is an important part of how we deliver the best care possible to the communities we serve. All offers of employment at Florida Cancer Specialists & Research Institute are contingent upon clear results of a thorough background screening. Additionally, as a condition of employment, FCS requires all new hires to receive various vaccinations, including the influenza vaccine, barring an approved exemption. In addition, FCS is a drug‑free workplace, and all new hires will be subject to drug testing. Medical Marijuana cards are not recognized.

EEOC

Florida Cancer Specialists & Research Institute (FCS) is committed to helping individuals with disabilities to participate in the workforce and ensure equal opportunity to compete for jobs.

FCS is an EEO/Affirmative Action Employer and does not discriminate on the basis of age, race, color, religion, gender, sexual orientation, gender identity, gender expression, national origin, protected veteran status, disability or any other legally protected status.

Exciting Benefits for Our Team!

At FCS our mission is to provide top‑ranked care to those we serve, and investing in our team is a big part of that commitment. Here’s a brief overview of some of the core benefits we provide for our team members:

• Medical and Prescription Drug Coverage
• Vision & Dental Insurance
• Employee Assistance Program (EAP)
• Health Savings Account (HSA) & Flexible Spending Accounts
• Paid Time Off (PTO)
• 401(k) Retirement Plan
• Life Insurance
• Tuition Reimbursement
• Disability Insurance
• Accident Insurance
• Critical Illness
• Hospital Indemnity
• Pet Insurance
• Identity Theft
• Legal Insurance

As a Community Oncology practice, we believe all FCS staff share a responsibility to promote, encourage, and model healthy lifestyles that reduce the likelihood of cancer. In support of this belief, Florida Cancer Specialists & Research Institute is a smoke‑free workplace. Being a smoke‑free workplace means smoking is not permitted on any FCS Campus or Property; Employees may not smell of smoke while at work, FCS does not provide smoke breaks and there are no designated smoking areas on FCS Campus or Property. Medical Marijuana cards are not recognized.