Pharmacy Prior Authorization Specialist

Position:Pharmacy Prior Authorization Specialist

Location: Pittsburgh, PA

Job :5412

# of Openings:1

Pharmacy Prior Authorization Specialist – Onco
360 Pharmacy
Full-Time | Starting at $23.00/hr and up

Full-Time position working out of the State of Pennsylvania. Must be licensed in the State of Pennsylvania to be eligible.
This position may work remotely

Sign-On Bonus: $5,000 for employees starting before August 31, 2026!

As our company continues to grow, we strive to hire new team members with a passion for making a difference in our patient's lives.

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.

• 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

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
• Pharmacy Technician License/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

• 3+ years of experience in pharmacy or prior authorizations
• Specialty pharmacy experience