Remote Pharmacy Prior Authorization Specialist – NM

Onco360 Oncology Pharmacy; Albuquerque (NM); Hybrid; USD 26,000 - 37,000; Full time

Benefits offered by this job

Medical, Dental, Vision

401k with match

Paid Time Off and Holidays

Tuition Reimbursement

Quarterly Incentive Bonus

Paid Volunteer Day

Referral Incentive Program

Life Insurance; Disability

Job summary

Onco360 Pharmacy in Albuquerque, NM is hiring a Pharmacy Prior Authorization Specialist to join a mission-driven team. This full-time role may include remote work if licensed in New Mexico.

You will manage prior authorizations with insurance carriers, collaborate with prescribers and pharmacists, ensure HIPAA compliance, and maintain accurate records.

Requirements include a high school diploma or GED, 1+ year of pharmacy or prior authorization experience, and state board registration.

Qualifications

• 1+ years of pharmacy or prior authorization experience.
• Knowledge of Medicare, Medicaid, and commercial insurance.
• Registration with Board of Pharmacy as required by state law.
• Strong communication and organizational skills.
• Ability to manage prior authorization requests and renewals.

Responsibilities

• Manage prior authorization requests and appeals with carriers.
• Collaborate with physicians, pharmacists, and staff to resolve denials.
• Ensure HIPAA-compliant handling of patient information.
• Maintain accurate authorization documentation.
• Proactively monitor expiring authorizations.

Skills

Prior authorization

Pharmacy experience

Communication skills

HIPAA compliance

Insurance claims knowledge

NCPDP claims knowledge

Coordination of benefits

Education

High School Diploma or GED

Associate degree or PTCB certification

Tools

CoverMyMeds

Job description

Onco360 Pharmacy in Albuquerque, NM is hiring a Pharmacy Prior Authorization Specialist to join a mission-driven team. This full-time role may include remote work if licensed in New Mexico.

You will manage prior authorizations with insurance carriers, collaborate with prescribers and pharmacists, ensure HIPAA compliance, and maintain accurate records.

Requirements include a high school diploma or GED, 1+ year of pharmacy or prior authorization experience, and state board registration.