Pharmacy Prior Authorization Specialist

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 Cover MyMeds

Preferred: Associate degree or Certified Pharmacy Technician (PTCB) 3+ years of experience in pharmacy or prior authorizations Specialty pharmacy experience