pharmacy billing specialist

Tampa General Hospital

<div><div><b>Pharmacy Billing Specialist - Outpatient Specialty</b> <b>-</b> <b>(</b><b>260001CE</b><b>)</b><div>
</div></div><div><b>
Description</b><div></div><p><br>
The Pharmacy Billing Specialist handles all medication billing functions within Pharmacy Services. Responsibilities include verifying insurance eligibility, facilitating prior authorizations, and collaborating with third-party payers and clinical offices. The specialist works with patients and providers to ensure access to medications and assists with denial appeals and financial assistance through funding sources. Additionally, the role involves auditing hospital pharmacy billing, resolving claim rejections, and supporting medical bill audits. The specialist performs duties in alignment with TGH&rsquo;s mission, vision, and values.</p><div><br>
</div></div><div><b>
Qualifications</b><div>
</div><ul><li>
Associate's Degree Relevant Field</li><li>
Registered Pharmacy Technician</li><li>
Two (2) years of experience in healthcare, retail, pharmacy, or billing. Experience may be considered in<br>
lieu of degree.</li></ul><div>
</div></div><div><b>
Primary Location</b><b>:</b> Tampa</div><div><b>
Work Locations</b><b>:</b> TGH Main Campus 1 Tampa General Circle Tampa 33601</div><div><b>
Eligible for Remote Work</b><b>:</b> Hybrid Remote</div><div><b>
Job</b><b>:</b> Pharmacy</div><div><b>
Organization</b><b>:</b> Florida Health Sciences Center Tampa General Hospital</div><div><b>
Schedule</b><b>:</b> Full-time</div><div><b>
Scheduled Days</b><b>:</b> Monday, Tuesday, Wednesday, Thursday, Friday</div><div><b>
Shift</b><b>:</b> Day Job</div><div><b>
Job Type</b><b>:</b> Hybrid Remote</div><div><b>
Shift Hours</b><b>:</b> Day shifts 8am to 4:30pm Monday to Friday</div><div><b>
Minimum Salary</b><b>:</b> 43,180.80</div><div><b>
Job Posting</b><b>:</b> Mar 31, 2026, 9:15:20 AM</div></div>

Pharmacy Billing Specialist - Outpatient Specialty

Afinida

<div><b>Position Overview:</b><br>
The Reimbursement/Billing Specialist is responsible for a portfolio of accounts receivable and oversees the billing cycle from charge review, claims submission and follow-up. The employee is engaged in a proactive and independent collection of outstanding balances for specially handled IV Services, LLC., pharmacy accounts. The Reimbursement/Billing Specialist will serve as the technical expert for complex workflows. The specialist is responsible for handling charge review edits, claim edits and preparation, insurance follow-up, denial resolution, and necessary follow-up to ensure accurate payment.<br>
<br>
<b>Supervisory Responsibilities:</b><ul><li>
None</li></ul><b>
Duties/Responsibilities:</b><ul><li>
Maintain a portfolio of accounts receivable for the pharmacy;
</li><li>Follow accounts through the Pharmacy revenue cycle, including but not limited to: verifying patient coverage information, updating registration, completing charge review, claim edits and claim submissions, and following up with third party payers and patients to facilitate prompt resolution of outstanding account balances;</li><li>
Communicate with Revenue Cycle teams, payors and others to resolve account problems; participate in meetings as needed to address payor concerns;</li><li>
Evaluate the payment status of outstanding third-party claims and resolve impediments to payment by providing information such as medical records, itemization of charges, information regarding other insurance benefits, and explanation of charges;</li><li>
Actively participates in both external third-party audits and in internal audits and quality improvement initiatives, maintains documentation of current workflows, assists with special projects, and works closely with third party billing teams, Dalrada Corporate Accounting teams, and with Pharmacy Department Leadership and Prior Authorization teams;</li><li>
Perform complex patient account follow-up activities and actively participates in quality improvement initiatives to improve accounts receivable processes;</li><li>
Accurate and timely processing of appeals to various pertinent payers or programs;</li><li>
Review and validate adjustments to accounts in the insurance portfolio based on insurance reimbursement, coverage, contracts and services provided;</li><li>
Review charges to ensure filing to correct guarantor (e.g. work comp vs. personal/family);</li><li>
Conduct collection calls to patients with outstanding balances and negotiate full payment from patients and/or assist patients in setting up a payment plan;</li><li>
Provide education to patients on UW Health&rsquo;s financial assistance policy and application process and direct patients to the appropriate resources as necessary (e.g. Financial Counseling, Patient Relations);</li><li>
Receive, document, and respond to all patient correspondence in a prompt and courteous manner; accurately document all actions taken to reconcile outstanding balances;</li><li>
Assist patients in coordinating appeal processes with their insurance company;</li><li>
Review self-pay undistributed and credit balance accounts and provide refunds to patients as necessary;</li><li>
Accurately post EFT, cash and checks made payable to IV Services, LLC., to the billing system;</li><li>
Ensure that all transactions are completed within the appropriate guidelines, policies and regulations, typically the same day received;</li><li>
Process electronic remittance files, payor work queues, and generate payment reports to balance;</li><li>
Communicate with IV Services, LLC., staff, insurance companies, financial institution and third-party payors to resolve issues related to proper posting of payments;</li><li>
Complete work on special projects, queries and reports as assigned;</li><li>
Other duties may be assigned as needed by management.</li></ul><b>
Required Skills/Abilities:</b><ul><li>
In-depth understanding of Pharmacy billing policies and procedures including NCPDP D.0 standards;</li><li>
Proficiency in spreadsheet and database software;</li><li>
Advanced analytic ability;</li><li>
Ability to make good judgments in demanding situations;</li><li>
Effective communication skills;</li><li>
Ability to logically and accurately organize details;</li><li>
Ability to manage multiple tasks with ease and efficiency;</li><li>
Ability to work independently and be result oriented;</li><li>
Positive, can-do attitude coupled with a sense of urgency;</li><li>
Effective interpersonal skills, including the ability to promote teamwork;</li><li>
Ability to ensure a high level of customer satisfaction including employees, patients, visitors, faculty, physicians and external stakeholders;</li><li>
Ability to use various computer applications including EPIC, Microsoft Office, etc;</li><li>
Basic math skills and knowledge of general accounting principles;</li><li>
Knowledge of medical and insurance terminology, CPT, ICD coding structures, and billing forms (UB, UCF, 1500);</li><li>
Maintain confidentiality of sensitive information;</li><li>
Knowledge of local, state and federal healthcare regulations.</li></ul><br>
<b>
Education and Experience:</b><ul><li>
An Associate degree in Business, Finance, Health Information Management, or related field preferred;</li><li>
3-5 years of experience in a healthcare revenue cycle or clinic operations role;</li><li>
3-5 years of experience in an infusion pharmacy setting;</li><li>
Experience with billing within the Caretend pharmacy platform;</li><li>
Experience billing acute infusion and specialty pharmacy claims.</li></ul><b>
Physical Demands and Work Environment:</b><ul><li>
While performing the duties of this job, the employee may be regularly required to stand, sit, talk, hear, reach, stoop, kneel, and use hands and fingers to operate a computer, telephone, and keyboard;</li><li>
Specific vision abilities required by this job include close vision requirements due to computer work;</li><li>
Light to moderate lifting may be required;</li><li>
Regular, predictable attendance is required; including quarter-driven hours as business demands dictate;</li><li>
Moderate noise (i.e., business office with computers, phone, and printers, light traffic);</li><li>
Ability to work in a confined area;</li><li>
Ability to sit at a computer terminal for an extended period;</li></ul><b>
Hourly Rate:</b><ul><li>
$28.00 an hour</li></ul><br>
<i>
Disclaimer:</i><br>
<br>
<i>This Job Description is only a summary of the typical functions of the position or role, not an exhaustive or comprehensive list of all possible responsibilities, tasks, and duties. Additionally, responsibilities, tasks, and duties of the employee in this role might differ from those outlined in the Job Description and other duties may be assigned on a permanent or temporary basis based on business needs.</i><p>
The Job Description is intended to be a general representation of the responsibilities and requirements of the job. However, the description may not be all-inclusive, and responsibilities and requirements are subject to change.</p>
<p>Equal Employment Opportunity</p>
<p>It is the policy of the Company to provide equal employment opportunities to all employees and employment applicants without regard to unlawful considerations of race, religion, color, national origin, sex, sexual orientation, gender identity or expression, age, sensory, physical, or mental disability, marital status, veteran or military status, genetic information, or any other classification protected by applicable local, state, or federal laws. This policy applies to all aspects of employment, including, but not limited to, hiring, job assignment, compensation, promotion, benefits, training, discipline, and termination. Reasonable accommodation is available for qualified individuals with disabilities, upon request.</p><p>
</p><p>wUL3sr7S2K</p></div>

Reimbursement/Billing Specialist

Polaris Pharmacy Services

<div><p><b>WHO WE ARE</b><br>
At Polaris Pharmacy Services, we&rsquo;re more than a pharmacy &mdash; we&rsquo;re a dedicated partner in care, transforming how patients experience long-term, post-acute, correctional, PACE, and specialty pharmacy services. As industry leaders, we&rsquo;re raising the bar for quality and coordination across all sites of care, ensuring every patient receives seamless, compassionate, and expert support.</p><p>
Founded in 2015, Polaris is proud to be locally and independently owned, with a growing national footprint. Our team thrives in a mission-driven environment where innovation meets purpose, and every role contributes to making a real impact. We offer more than just a job &mdash; we provide competitive pay, robust benefits, and genuine opportunities for career advancement.</p><p>
If you're passionate about shaping the future of pharmacy and making a difference in the lives of those who need it most, we invite you to grow with us.</p><p><b>
JOB SUMMARY:</b></p><p>
The Billing Specialist is responsible for Nursing Homes, Assisted Living Facilities, Group Homes, and Private Pay statements.</p><p><b>
Day: (9am-5pm, 10am-6pm)</b></p><p><b>
Evening: (12pm-8pm)</b></p><p><b>
DUTIES/RESPONSIBILITIES:</b></p><ul><li>
Process third-party billing, claim resolution, and adjudication</li><li>
Manage FFS and PPS billing</li><li>
Conduct census balancing and payor verification</li><li>
Verify insurance and Medicaid coverage</li><li>
Knowledge of Dual Coverage, MCR D, and Commercial Plans pertaining to Long Term Care</li><li>
Assist with all customer billing inquiries in a courteous and professional manner</li><li>
Enter fees and charges in Framework LTC</li><li>
Prepare daily, weekly, and monthly pre-bills and account audits</li><li>
Prepare daily, weekly, and monthly reports
</li><li>Create statements and EOM summaries</li><li>
Understand and work with residents on account balances</li><li>
Follow all applicable government regulations including HIPAA</li><li>
Other duties as deemed necessary by Billing Manager</li></ul><p><b>
QUALIFICATIONS/COMPETENCIES:</b></p><p>
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p><p><b>
REQUIRED SKILLS/ABILITIES:</b></p><ul><li>
Able to read, write, speak, and understand the English language</li><li>
Able to work in a fast-paced environment</li><li>
Basic computer knowledge skills required</li><li>
Basic math and analytical skills</li><li>
Proficient in Microsoft Word, Excel, and Outlook required</li><li>
Good organization/Attention to detail</li><li>
Able to work at a moderate speed
</li><li>Reliable</li><li>
Problem solver
</li><li>Able to work various shifts and days</li><li>
Adaptability to an ever-changing environment</li></ul><p>
</p><p><b>EDUCATION and/or EXPERIENCE:</b></p><p>
</p><p></p><ul><li>High School diploma or equivalent required</li><li>
Two (2) years&rsquo; pharmacy billing experience required (long-term care preferred)</li><li>
Framework LTC &amp; General computer knowledge &amp; 10-key Number Entry preferred</li><li>
Knowledge of Sage preferred</li></ul><p>
</p><p></p><p><b>PHYSICAL DEMANDS</b></p><p>
</p><p></p><p>The physical demands described here are representative of those that should be met by an employee to successfully perform the essential functions of this job:</p><p>
</p><ul><li>May sit or stand seven (7) to ten (10) hours per day</li><li>
The employee is occasionally required to sit; climb or balance; and stoop, kneel, bend, walk</li><li>
May be necessary to work extended hours as needed</li><li>
May lift and/or move up to 30 pounds</li><li>
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this role</li></ul><p><b>
HOLIDAY &amp; PTO POLICY</b></p><ul><li>
Paid holidays are provided annually, with 6 days offered each year, along with 5 sick days.</li><li>
Employees earn up to 10 PTO days each year, with rollover options and milestone bonuses.</li><li>
Employees have the option to cash out up to 10 PTO hours each quarter for added financial flexibility.</li></ul><p>
Please note, because we are a pharmacy most of our locations are open 24-hours a day, 7 days a week and therefore schedules may change as determined by the needs of the business.</p><p><b>
BENEFITS for full time Employees</b></p><ul><li>
Medical, Dental, and Vision insurance</li><li>
401 (k) (available for Part Time &amp; Full Time EEs)</li><li>
Company Paid Life insurance</li><li>
Short-term and Long-term disability insurance</li><li>
Tuition reimbursement</li><li>
Personal Time Off (PTO)</li><li>
Competitive pay with annual performance reviews and merit-based raises</li><li>
Career growth potential</li><li>
Annual on-site voluntary Flu Vaccines</li><li>
Employee referral bonus program</li></ul></div><p></p>

Billing Specialist

The University of Iowa

<div><div>The Department of Pharmaceutical Care is seeking a full-time <b>Pharmacy Support Services Specialist</b> to join our Specialty Pharmacy team. The Support Services Specialist provides prescription support services for patients to assure effective and efficient delivery of health care. This position requires strong computer skills, a high level of attention to detail, accurate documentation skills, strong organizational and problem solving skills, a general knowledge of hospital and prescription billing practices, and excellent customer services skills. This position will work closely with other staff within the hospital to support specialty pharmacy medication adherence management (management of patient refill coordination), complete routine pharmacy billing activities, and assist with shipping issues. This position is located off the main campus at our ACT Building in Iowa City.</div><div><b>
Duties to include:</b></div><div><b>
Patient Adherence Management</b></div><ul><li><div>
Manage refill services for select patient populations in accordance with department policies and procedures.</div></li><li><div>
Communicate via phone and electronically with patients, pharmacist, providers and other health care team members regarding patient adherence issues.</div></li><li><div>
Monitor and manage inventory activities related to patient prescription needs.</div></li><li><div>
Provide accurate documentation of all patient interactions/assessments as required by accrediting agencies, payers and/or administration.</div></li></ul><div><b>
Enrollment of patients in specialty pharmacy services including:</b></div><ul><li><div>
Communication with patient, pharmacist and/or provider to gather relevant demographic information, shipping and contact preferences.</div></li><li><div>
Provision of appropriate enrollment and contact information.</div></li><li><div>
Provides highest customer service experience for patients and providers.</div></li></ul><div><b>
Communication/Training:</b></div><ul><li><div>
Understand the importance of effective business communication and maintaining professionalism in difficult situations.</div></li><li><div>
Participate in orientation of pharmacy technicians, pharmacists, pharmacy residents and others within the department on pharmacy practices.</div></li></ul><div><b>
Problem Resolution</b></div><ul><li><div>
Provide assistance with the resolution of shipment/delivery issues.</div></li><li><div>
Communicate with providers, payors, patients, co-workers, supervisors and departments to resolve complex insurance issues.</div></li><li><div>
Provide assistance to patients with billing and claim resolution issues</div></li></ul><div><b>
Provide documentation of all activities as required by accrediting agencies, payers and/or administration, including:</b></div><ul><li><div>
Workload statistics (enrolled/active patients, mail outs, etc)</div></li><li><div>
Phone statistics</div></li></ul><p><b>
Assists with evaluation and implementation of new policy and procedures</b></p><ul><li><div>
Participate in piloting new workflows/procedures</div></li><li><div>
Assist with preparing training and orientation materials for new procedures</div></li><li><div>
Assist with training and orientation of staff to new procedures</div></li><li><div>
Assist with specialty pharmacy service equipment modifications, reorganization, and additions to implement new policy and procedure</div></li></ul><div><b>
Other duties as assigned</b></div><ul><li><div>
Provide cross functional support to assist with communication and enrollment of patients into copay/coinsurance assistance and grant programs</div></li><li><div>
Provide cross functional support to assist with troubleshooting claim payments</div></li></ul><p>
Pay Level: 3A https://hr.uiowa.edu/pay/professional-and-scientific-compensation/professional-and-scientific-job-classifications-pay</p>
<div><div><b>Education Requirements:</b></div><ul><li><div>
Completion of a Bachelor&rsquo;s degree or equivalent combination of education and experience.</div></li><li><div>
Iowa Board of Pharmacy registration as Pharmacy Trainee required prior to commencement of employment.</div></li><li><div>
Successful completion of the pharmacy technician certification exam within one year of the start of employment.</div></li></ul><div><b>
Experience Requirements:</b></div><ul><li><div>
Previous experience (typically 6-12 months) in support or customer service.</div></li><li><div>
Experience and proficiency with computer software applications (i.e. Microsoft Office Suite &ndash; Word, Excel, Outlook, PowerPoint) or comparable programs.</div></li><li><div>
Strong attention to detail and proven ability to gather and analyze data and keep accurate records.</div></li><li><div>
Self-motivated with initiative to seek out additional responsibilities and tasks along with generating suggestions for improving workflow.</div></li><li><div>
Effective verbal and written communication skills, active listening skills and the ability to maintain professionalism while handling difficult situations.</div></li><li><div>
Demonstrate effective problem-solving abilities and meets challenges with resourcefulness.</div></li><li><div>
Familiarity with medical terminology.</div></li></ul><div><b>
Desired Qualifications:</b></div><ul><li><div>
Experience working in a complex hospital system is highly desirable.</div></li><li><div>
Experience working in a collaborative team environment is desirable.</div></li><li><div>
Pharmacy experience is desirable.</div></li><li><div>
Knowledge of healthcare billing, experience working with insurance and/or federal and state assistance programs is desirable.</div></li><li><div>
Experience working with multiple technology platforms (i.e. Epic, GE) is desirable.</div></li><li><div>
Knowledge and understanding of the Health Insurance Portability and Accountability Act (HIPAA) is desirable.</div></li><li>
Professional experience working effectively with individuals from a variety of backgrounds and perspectives.</li></ul><div><b>
Position and Application details:</b></div><div>
In order to be considered for an interview, applicants must upload the following documents and mark them as a &ldquo;Relevant File&rdquo; to the submission:</div><ul><li><div>
Resume</div></li><li><div>
Cover Letter</div></li></ul><div>
Job openings are posted for a minimum of 7 calendar days and may be removed from posting and filled any time after the original posting period has ended.</div><div>
Successful candidates will be required to self-disclose any conviction history and will be subject to a criminal background check and credential/education verification.<br>
Up to 5 professional references will be requested at a later step in the recruitment process. For additional questions, please contact Teresa Walker at Teresa-Walker@uiowa.edu.</div><div><p>
This position is eligible for a combination of remote work and in-person (hybrid) work within Iowa. To be eligible for the hybrid remote work option, staff must be working in the position for a minimum of 6 months, must have successfully completed all training requirements, and must be meeting or exceeding expectations as assessed in a formal performance review or by leadership. A work arrangement form will be required to be completed prior to the start of remote work. Per policy, work arrangements will be reviewed annually, and must comply with the remote work program and related policies and employee travel policy when working at a remote location.</p></div></div></div><div></div>

Pharmacy Support Services Specialist (Hybrid) Offsite Integrated Pharmacy Services Center Campus

Oregon Healthcare Pharmacy Services, Inc.

<p>Immediate opening for a Full Time Billing/Prescription Entry Pharmacy Technician. Must be licensed in State of Illinois and/or in process of becoming certified. Ability to multi-task, detail oriented, self starter, with desire to work with people in a relaxed environment. No Long Term Care Pharmacy experience required. Must have experience in Billing/Claims Processing and Prescription Entry, with job duties including prescription processing, claim processing, prior authorization adjudication, management of inventory, processing of contingency kits, and delivery manifest reconciliation. Must possess excellent communication skills, detail oriented, and experience and basic aptitude in using pharmacy software/computers a plus. This is not a remote position.</p><p>Job Type: Full-time</p><p>Pay: $18.00 - $22.00 per hour</p><p>Benefits:</p><ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Flexible schedule</li><li>Health insurance</li><li>Health savings account</li><li>Life insurance</li><li>Paid time off</li><li>Retirement plan</li><li>Vision insurance</li></ul><p>Work Location: In person</p>

Billing/Prescription Entry Pharmacy Technician - Oregon, IL

Onco360

<div><div><b>Are you someone looking for professional career growth? </b>Onco360 Pharmacy is looking for <b>Senior </b><b>Pharmacy Benefit Verification Specialist </b>for our Pharmacy located in Louisville, KY<b>.</b> Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers.
</div>
<div></div><div><b>Current shift available: 10:30am-7:00pm EST</b></div>
<div></div><div><b>**Starting salary at $26/HR and up**</b></div>
<div></div><div><div>We offer a great benefits including:</div>
<ul><li>Medical; Dental; Vision</li>
<li>401k with a match</li>
<li>Paid Time Off and Paid Holidays</li>
<li>Tuition Reimbursement</li>
<li>Company paid benefits &ndash; life; and short and long-term disability</li>
</ul></div><div><div><b>Senior Pharmacy </b><b>Benefit Verification</b><b> Specialist Major Responsibilities:</b></div>
<div>The Senior Benefit Verification Specialist will work closely with the Senior Manager, Patient Benefits to ensure completion of challenging cases and escalations in their designated vertical. Senior Benefits Verification Specialists will investigate, review, and load accurate patient insurances, including medical and pharmacy coverage, assign coordination of benefits, run test claims to obtain a valid insurance response on patient medications, investigate/identify authorization requirements needed to obtain medication coverage, and enroll eligible patients in copay card assistance programs. They will ensure accurate benefit documentation is made for all prescription orders. They may also assist with training employees, and other duties as assigned.</div>
<ul><li>Works and resolve difficult or escalated cases to assist in processing prescription orders</li>
<li>Participates in the orientation and training of benefit verification specialists within workflow vertical</li>
<li>Escalates workflow/process improvement ideas to leadership</li>
<li>Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests</li>
<li>Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding benefit information</li>
<li>Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information</li>
<li>Performs full benefits verification on patients for pharmacy benefits and/or medical benefit utilizing electronic resources and E1 check to load primary, secondary, tertiary, etc. insurances and medical insurances to patient profile</li>
<li>Run test claims at each licensed pharmacy site to obtain a valid claim response and determine optimal reimbursement, then document outcome of benefits review in CPR+ system to be used by operations and ensure the order is assigned to the appropriate dispensing pharmacy</li>
<li>Facilitate process for requesting medical authorizations, LOAs, and TOAs for applicable commercial, Medicaid, and Medicare, or facility medication claims</li>
<li>Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws</li>
<li>Contributes to team effort by accomplishing related tasks as needed and other duties as assigned</li>
<li>Conducts job responsibilities in accordance with the standards set out in the Company&rsquo;s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.<br>
</li></ul><div><b>Senior Pharmacy </b><b>Benefit Verification</b><b> Specialist Qualifications:</b></div>
</div><ul><li>Education/Learning Experience
<ul><li>Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification</li>
<li>Desired: Associates or Bachelor&rsquo;s Degree, Certified Pharmacy Technician (PTCB), Specialty pharmacy experience</li>
</ul></li><li>Work Experience
<ul><li>Required: 2+ years pharmacy or benefit verification experience</li>
<li>Desired: 3+ years pharmacy or benefit verification experience</li>
</ul></li><li>Skills/Knowledge:
<ul><li>Required: Pharmacy insurance and benefit verification, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills.<br>
Desired: Specialty pharmacy experience, leadership skills</li>
</ul></li><li>Licenses/Certifications
<ul><li>Required: Registration with Board of Pharmacy as required by state law</li>
<li>Desired: Certified Pharmacy Technician (PTCB)</li>
</ul></li><li>Behavior Competencies
<ul><li>Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skills</li></ul></li></ul></div>

Senior Pharmacy Benefit Verification Specialist

<div><div><b>Pharmacy Prior Authorization Specialist &ndash; Onco360 Pharmacy</b><br>
<i>New Hyde Park, NY</i> | <i>Full-Time</i> | <i>Starting at $25.00/hr and up</i></div>
<div></div><div><b>Join a mission-driven team making a difference in the lives of cancer and rare disease patients.</b></div>
<div></div><div>Onco360 Pharmacy is seeking a <b>Pharmacy Prior Authorization Specialist</b> to join our dedicated team in New Hyde Park, NY. This is a full-time position ideal for candidates local to the area. Remote work possible after initial on-site training.</div>
<div> </div><p></p><div><div><b>Why Join Us?</b></div>
<ul><li>A career with purpose: Help patients access life-saving medications.</li>
<li>Supportive culture: We value <b>teamwork, respect, integrity, and passion</b>.</li>
<li>Growth opportunities: We invest in your professional and personal development.</li>
</ul>
</div><div></div><div><b>Company Benefits</b></div>
<ul><li>Medical; Dental; Vision</li>
<li>401k with a match</li>
<li>Paid Time Off and Paid Holidays</li>
<li>Tuition Reimbursement</li>
<li>Quarterly Incentive Bonus</li>
<li>Paid Volunteer Day</li>
<li>Referral Incentive Program</li>
<li>Company Paid Life Insurance; and Short/Long-Term Disability</li>
</ul><p></p><div><b>What You&rsquo;ll Do</b></div>
<div>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.</div>
<div></div><div><b>How You&rsquo;ll Do This</b></div>
<ul><li>Manage prior authorization requests and appeals with insurance carriers.</li>
<li>Collaborate with physicians, pharmacists, and other departments.</li>
<li>Ensure HIPAA compliance while handling sensitive patient information.</li>
<li>Maintain accurate documentation of authorization details.</li>
<li>Proactively monitor and renew expiring authorizations.</li>
</ul> <p></p><div><b>What You Bring</b></div>
<div><b>Required:</b></div>
<ul><li>High School Diploma or GED</li>
<li>1+ years of pharmacy or prior authorization experience</li>
<li>Registration with Board of Pharmacy (as required by state law)</li>
<li>Strong communication, organizational, and customer service skills</li>
<li>Self-motivated, organized, detail-oriented, and adaptable to changing priorities</li>
<li>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</li>
</ul><div><b>Preferred:</b></div>
<ul><li>Associate degree or Certified Pharmacy Technician (PTCB)</li>
<li>3+ years of experience in pharmacy or prior authorizations</li>
<li>Specialty pharmacy experience</li>
</ul><p></p><div><b>Ready to make a meaningful impact? Apply today and help us better the lives of those battling cancer.</b></div>
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Pharmacy Prior Authorization Specialist

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