Prior Authorization Specialist

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Position: Prior Authorization Specialist

Location: Buffalo

Job :631

# of Openings:1

Pharmacy Prior Authorization Specialist – Care Med Specialty Pharmacy Buffalo, NY | Full-Time | Starting at $23.00/hr and up

Join a mission-driven team making a difference in the lives of cancer patients.

Care Med Specialty Pharmacy is seeking a
Pharmacy Prior Authorization Specialist
to join our dedicated team in Buffalo, NY. This is a full-time position ideal for candidates local to the area. Remote work possible after initial on-site training.

• 401k with a match
• Paid Time Off and Paid Holidays
• Tuition Reimbursement
• Quarterly Incentive Bonus
• Referral Incentive Program
• Company Paid Life Insurance; and Short/Long-Term Disability

• 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.

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.

• 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 My Meds

Preferred:

• 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.