Pharmacy Prior Authorization Specialist
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Onco360
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Pharmacy Prior Authorization Specialist
Onco360
Posted 2 months ago
Full Time
Woodridge, Illinois
Remote OK
Smart Summary
Responsibilities
The Pharmacy Prior Authorization Specialist manages prior authorization requests and appeals with insurance carriers to ensure patients receive necessary medications. They also collaborate with healthcare professionals and maintain accurate documentation while ensuring HIPAA compliance.
Qualifications
You have a High School Diploma or GED and at least 1 year of experience in pharmacy or prior authorizations. You are expected to have knowledge of pharmacy terminology, insurance claims, and specific billing processes. Registration with the Board of Pharmacy is also a requirement.
Must Have Skills for ATS
Pharmacy Prior Authorization
Insurance Claims
Medicare
Medicaid
Commercial Insurance
NCPDP
Coordination of Benefits
NDC
CoverMyMeds
HIPAA
Job Description
Woodridge, IL | Full-Time | Starting at $23.00/hr and up Join a mission-driven team making a difference in the lives of cancer patients. Onco360 Pharmacy is seeking a Pharmacy Prior Authorization Specialist to join our dedicated team in Woodridge, IL. 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.
- 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
- 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. #Company Values: Teamwork, Respect, Integrity, Passion #IH
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Onco360
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