Pharmacy Prior Authorization Specialist Job Waltham Massachusetts USA,Healthcare

Pharmacy Prior Authorization Specialist - Onco
360 Pharmacy Waltham, MA | Full-Time | Starting at $23.00/hr and up Sign-On Bonus: $5,000 for employees starting before September 30, 2026!
Join a mission-driven team making a difference in the lives of cancer and rare disease patients. Onco
360 Pharmacy is seeking a Pharmacy Prior Authorization Specialist to join our dedicated team in Waltham, MA. 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.

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 My Meds

Preferred:

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