prior authorization technician

Aditi Consulting

<div>
 <br/>
 <span>
  <span>
   <strong>
    Payrate:
   </strong>
   $17.00 - $18.00/hr.
   <br/>
   &nbsp;
   <br/>
   <strong>
    Summary:
    <br/>
   </strong>
   The Pharmacy Prior Authorization Technician performs functions as permitted by law including the initial level processing and review of prior authorization requests for both pharmacy reviews and medical specialty drug reviews. These reviews are performed utilizing pharmacy management drug policies and procedures. This position accurately prepares and interprets cases for UM (utilization management) reviews and determination. In addition, the Technician is the content expert for the applications used to process these requests. The Technician acts as a resource for staff regarding members&rsquo; specific contract benefits, consistent with products, policies and procedures and related health plan functions such as member services, claims, and the referral/authorization process. This position provides leadership and expertise in the intake area of the prior authorization process for medications processed either through the pharmacy or medical benefit and in processing exception/prior authorization requests that follow standard protocols.
   <br/>
   &nbsp;
   <br/>
   <strong>
    Responsibilities:
   </strong>
  </span>
 </span>
 <ul>
  <li>
   <span>
    <span>
     Conducts an initial level medication prior-authorization, exception and medical necessity reviews submitted to the plan to determine coverage under the member&rsquo;s benefit.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Routes cases directly to the pharmacist/medical director for final determination, as directed.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Issues verbal and written member notification as required.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Reviews and interpret prescription and medical benefit coverage across all lines of business including Medicare D to determine what type of prior authorization review is required, documents any relevant medication history and missing information to assist the pharmacist/nurse/physician in the review process.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Develop and implement process improvement to increase efficiency in the review process for the clinical staff.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Works with requesting providers, clinical pharmacists, and other internal staff, as appropriate, in determining whether specific case presentation meets the criteria for approval according to the medical or prescription drug policy and specific coverage criteria.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Can point out nuances that may not be readily apparent regarding the request.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Contacts pharmacies and physician offices as necessary to obtain clarification on prior authorization requests and drugs being billed through the point-of-sale system and/or medical claim system in order to optimize the member experience.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Acts as lead troubleshooter for the pharmacy help desk, customer care and claim processors to coordinate pharmacy and/or medical claims with prior authorization information on file or needed for the member.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Responsible for assuring appropriate auth entry across all lines of business. Ensure care management system interfaces to claim processing system for claim payment. Manual manipulation of auth may be required upon case completion.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Performs system testing as required for upgrades and enhancements to the care management system.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Acts as a content expert for prior authorization intake for our customers, both internal and external. Serves as department subject matter expert for pharmacy and medical drug authorizations and coverage.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Serves as lead liaison for the prior authorization process and its interface to the pharmacy and medical claim systems to troubleshoot. Triages issues to the appropriate department for resolution.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Triages prior authorization workflow daily by rerouting cases, alerting clinical staff of time frame deadlines, monitoring work queues and keeping management aware of issues related to compliance mandated time frames for review completion.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Provides phone coverage for incoming calls as required to support the UM process. This may include authorization inquiries and information requests, claim inquiries, and other related inquiries. Provides friendly, accurate and timely assistance.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Supports medical and pharmacy drug pricing questions, and uses drug lookup tools such as government sites, and other online resources.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Maintains thorough knowledge and understanding of sources of information about health plan contracts, riders, policy statements, and procedures to identify eligibility and coverage and assisting other staff with related inquiries.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Performs unit specific workflow processes consistent with corporate medical &amp; administrative policies, employer specific guidelines, and/or regulatory agencies.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Produces, records, or distributes information to others. On a periodic basis, tracks and reports department performance against benchmarks.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Prepares and assists in handling correspondence. Assures accuracy and timeliness of processing.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Participates in interdepartmental coordination and communication to ensure delivery of consistent and quality health care services examples include Utilization Management, Quality Management and Case Management.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Produces, at minimum, the team average medication prior-authorization, exception and medical necessity reviews submitted to the plan to determine coverage under the member&rsquo;s benefit.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies&rsquo; mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Regular and reliable attendance is expected and required.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Performs other functions as assigned by management.
    </span>
   </span>
  </li>
 </ul>
 <span>
  <span>
   &nbsp;
   <br/>
   <strong>
    Requirements:
   </strong>
  </span>
 </span>
 <ul>
  <li>
   <span>
    <span>
     High school diploma with a minimum of two years&rsquo; experience in health-related field is required. Associates degree preferred.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Pharmacy Technician certification (CPhT), LPN, Medical Assistant/Technologist background strongly preferred.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Ability to work prolonged periods sitting at a workstation and working on a computer.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Ability to work while sitting and/or standing while at a workstation viewing a computer and using a keyboard, mouse and/or phone for three (3) or more hours at a time.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Typical office environment including fluorescent lighting.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Ability to work in a home office for continuous periods of time for business continuity.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     Ability to travel across the Health Plan service region for meetings and/or trainings as needed.
    </span>
   </span>
  </li>
  <li>
   <span>
    <span>
     The ability to hear, understand and speak clearly while using a phone, with or without a headset.
    </span>
   </span>
  </li>
 </ul>
 <span>
  <span>
   &nbsp;
   <br/>
   <strong>
    Pay Transparency:
   </strong>
   <em>
    The typical base pay for this role across the U.S. is:
    <strong>
     $17.00 - $18.00 /hour
    </strong>
    . Non-exempt positions are eligible for overtime at a rate of 1.5 times the base hourly rate for all hours worked in excess of 40 in a work week, or as required by state or local law. Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education and experience. Full-time employees are eligible to select from different benefits packages. Packages may include medical, denmatch, lifeion benefits, health savings accounts with qualified medical plan enrollment, 10 paid days off, 3 days paid bereavement leave, 401(k) plan participation with employer match,&nbsp; life and disability insurance, commuter benefits, dependent care flexible spending account, accident insurance, critical illness insurance, hospital indemnity insurance, accommodations and reimbursement for work travel, and discretionary performance or recognition bonus. Sick leave and mobile phone reimbursement provided based on state or local law.&nbsp;
    <br/>
   </em>
   &nbsp;
   <br/>
   <strong>
    <em>
     Consent to Communication and Use of AI Technology:
    </em>
   </strong>
   <em>
    By submitting your application for this position and providing your email address(es) and/or phone number(s), you consent to receive text (SMS), email, and/or voice communication whether automated (including auto telephone dialing systems or automatic text messaging systems), pre-recorded, AI-assisted, or individually initiated from Aditi Consulting, our agents, representatives, or affiliates at the phone number and/or email address you have provided. These communications may include information about potential opportunities and information. Message and data rates may apply. Message frequency may vary.
    <br/>
   </em>
   <em>
    You represent and warrant that the email address(es) and/or telephone number(s) you provided to us belong to you and that you are permitted to receive calls, text (SMS) messages, and/or emails at these contacts. You also acknowledge and agree to Aditi Consulting LLC&rsquo;s use of AI technology during the sourcing process, including calls from an AI Voice Recruiter. AI is used solely to gather data and does not replace human-based decision-making in employment decisions.  Calls may be recorded.
    <br/>
   </em>
   &nbsp;
   <br/>
   <em>
    Consent is not a condition of purchasing any property, goods, or services. You may revoke your consent at any time by replying &ldquo;STOP&rdquo; to messages or by contacting privacy@aditiconsulting.com.
    <br/>
   </em>
   <em>
    For information about our collection, use, and disclosure of applicant's personal information as well as applicants' rights over their personal information, please see our
   </em>
   <em>
    Privacy Policy
   </em>
   <em>
    .
    <br/>
   </em>
   &nbsp;
   <br/>
   #AditiConsulting
   <br/>
   #26-01637
   <br/>
  </span>
 </span>
</div>


Pharmacy Prior Authorization Technician

Indiana University Health

<div><div><div><div><h1 class="jobSectionHeader"><b>Pediatric Outpatient Prior Authorization Pharmacy Technician</b></h1>
</div></div><div></div><div><h2 class="jobSectionHeader"><b>Job Description</b></h2>
<div><p><b>Overview</b>
</p><p><b>Overview</b></p><p>
We are looking for team members who are passionate about challenging and significant work for the good of every patient. We are searching for individuals who are compassionate, serve with a purpose, are dedicated to supporting their team, and who seek excellence every day.</p><p>
Sound like a perfect match? Apply now - we can't wait to hear from you!</p><p><b>
Why Join IU Health?</b></p><p>
As Indiana&rsquo;s largest and most comprehensive healthcare system, and the number 1 ranked healthcare system in Indiana, we offer:</p><ul><li>
401(K) retirement savings with employer match</li><li>
Tuition reimbursement</li><li>
Student loan forgiveness - Government program that may allow qualifying participants to have the remainder of their student loan balance forgiven (after a set amount of time and specific qualifications have been met).</li><li>
Employee Assistance Program &ndash; Counseling at no cost to you</li><li>
Healthy Results - Participation in our team member wellness programs award points that contribute toward a biweekly financial incentive in your paycheck! The more you participate, the more you earn!</li></ul><p><b>
Description:</b></p><p><b>
This is a full time, day shift Prior Authorization Pharmacy Technician position for Riley Hospital for Children's Outpatient Pediatric Gastro Clinic in Indianapolis, IN. There will be in person, on site training required until fully trained. The position will then transition to remote work.</b></p><p>
Riley Pediatric Gastroenterology is seeking an experienced Pharmacy Technician to support our busy specialty practice. This role focuses on initiating and completing prior authorizations, working closely with a collaborative and inclusive team.</p><p>
What to expect:</p><ul><li><p>
Up to six months of onsite training</p></li><li><p>
Remote work available after training</p></li><li><p><i>
This is not a retail pharmacy role.</i></p></li></ul><p></p><p><b><br>
Qualifications:</b></p><ul><li>
High School Diploma/GED is required.
</li><li>Requires Indiana Pharmacy Tech-In Training OR Indiana Pharmacy Technician License OR intern/extern license if enrolled in accredited college of pharmacy.
</li><li>Requires Pharmacy Technician National Certification within one year of hire unless enrolled in accredited college of pharmacy or enrolled in or graduated from an ASHP/ACPE accredited Pharmacy Technician training program.
</li><li>Requires the absence of criminal history related to the ability to work with drugs.
</li><li>Requires strong mathematical calculation skills.</li><li>
Requires ability to learn basic pharmacy technician skills in assigned areas and work under close supervision or under clearly defined procedures.</li><li>
Requires ability to learn effective written and communication skills.
</li><li>Requires ability to learn and execute customer services skills.</li><li>
Requires basic proficiency typing and using Microsoft office applications.</li></ul><br>
</div><p></p><div><p>We are an equal opportunity employer. IU Health does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.</p>
</div></div></div><div></div><div><div><div><p>Indiana University Health is Indiana&rsquo;s most comprehensive health system, with 15 hospitals and nearly 40,000 team members serving Hoosiers across the state. Our partnership with the Indiana University School of Medicine gives our team members access to the very latest science and the very best training, advancing care for all. We&rsquo;re looking for team members who share the things that matter most to us. People who are inspired by challenging and meaningful work for the good of every patient. People who are compassionate and serve with a purpose. People who aspire to excellence every day. People who are always ready to apply themselves.</p></div></div></div></div>

Pediatric Outpatient Prior Authorization Pharmacy Technician

Molina Healthcare

Molina Healthcare is hiring for remote Certified Pharmacy Technicians. These roles will be in our Prior Authorization department.
<br><br>
You will review prior auth requests that are submitted.
<br><br>
Schedules for these roles will be Mon through Fri 11am-7:30pm MST or 12:30pm-9pm MST. The training schedule will be approximately 7 weeks 9am-5:30pm MST.
<br><br>
Qualified candidates must have either PTCB certification or Pharmacy Tech State license. High preference for those who are self-starters and go-getters. Must have above average computer skills along with a high level of communication skills both written and verbal.
<br><br>
As a Pharmacy Tech here at Molina, you will provide support for pharmacy technician activities. You will also contribute to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care.
<br><br>
Essential Job Duties
<br><br>
Performs initial receipt and review of non-formulary or prior authorization requests against pharmacy plan approved criteria; requests additional information from providers as needed to properly evaluate requests.
<br><br>
Accurately enters approvals or denials of requests.
<br><br>
Facilitates prior authorization requests within established pharmacy policies and procedures.
<br><br>
Participates in the development/administration of pharmacy programs designed to enhance the utilization of targeted drugs and identification of cost-saving pharmacy practices.
<br><br>
Identifies and reports pharmacy departmental operational issues and resource needs to appropriate leadership.
<br><br>
Assists Molina member services, pharmacies, and health plan providers in resolving member prescription claims, prior authorizations, and pharmacy service access issues.
<br><br>
Articulates pharmacy management policies and procedures to pharmacy/health plan providers, Molina staff and others as needed.
<br><br>
Required Qualifications
<br><br>
At least 2 years pharmacy technician experience, or equivalent combination of relevant education and experience.
<br><br>
Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice.
<br><br>
Ability to abide by Molina policies.
<br><br>
Ability to maintain attendance to support required quality and quantity of work.
<br><br>
Ability to maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA).
<br><br>
Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.
<br><br>
Excellent verbal and written communication skills.
<br><br>
Microsoft Office suite (including Excel), and applicable software program(s) proficiency.
<br><br>
<b>To all current Molina employees:</b> If you are interested in applying for this position, please apply through the Internal Job Board.
<br><br>
Molina Healthcare offers competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
<br><br>
<b>Pay Range:</b> $12.19 - $26.42 / HOURLY
<br><ul>
<li>Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.</li>
</ul>


Pharmacy Technician (Remote) Prior Auth

CVS Health

<div>
 We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.
 <br/>
 <br/>
 <strong>
  Position Summary
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Processes prior authorization requests received by phone, fax, or electronically, and utilizes various computer resources, existing criteria, and medication guidelines to perform clinical research to support prior authorization reviews.
  </li>
  <li>
   Proactively completes prior authorization approvals and denials that are due to expire and maintains complete, timely, and accurate documentation.
  </li>
  <li>
   Reviews potential prior authorization denial language to ensure NCQA requirements are met.
  </li>
  <li>
   Follows prior authorization workflow, policies, and procedures during the course of the workday.
  </li>
  <li>
   Answers a potentially high volume of prior authorization inquiry calls from provider's offices, pharmacies, members, and internal partners, and uses various computer resources to communicate prior authorization status or decisions.
  </li>
  <li>
   Maintains a balance of productivity, quality, and timeliness of work.
  </li>
  <li>
   Participates in training and continuing education as required.
  </li>
  <li>
   Participates in team/departmental meetings as required.
  </li>
  <li>
   Excellent attendance is a must.
  </li>
  <li>
   Successful pharmacy technicians will be proficient in drug name and diagnosis pronunciation, recognizing medical terminology, and navigating multiple computer resources to document conversations and prior authorization decisions.
  </li>
  <li>
   Successful pharmacy technicians will possess good written and verbal communication skills.
  </li>
  <li>
   Hours of operation for Aetna Pharmacy Prior Authorization are between 5:00am to 7:00pm (may vary by time zone). Pharmacy Technicians work 8 hour shifts that may fall in between these hours of operations. Overnight shifts may also be available, but not guaranteed. Work schedule is approximate, and hours/days may change based on company needs. All full-time employees are required to complete forty (40) hours per week as scheduled, including on weekends and holidays. Part time positions are not available. Position requires the ability to work extended hours when necessary.
  </li>
  <li>
   Rotating weekend schedule may be required.
  </li>
  <li>
   Candidate must have their own home internet access with minimum speed of 100mbps download (internet should be hard wired with Ethernet cord).
  </li>
  <li>
   Candidate must have a secure workspace/office in their home.
  </li>
  <li>
   Candidate must have high level skill with working with a PC (ex. using mouse and keyboard, accessing and navigating through multiple systems and screens).
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Required Qualifications
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   National Pharmacy Technician certification and state licensure or applicable state Pharmacy Technician license, current and in good standing, are required and must be maintained
  </li>
  <li>
   Between 0-5+ years of Pharmacy Technician experience
  </li>
  <li>
   Ability to multi-task and prioritize work
  </li>
  <li>
   Ability to adjust based on business or department needs
  </li>
  <li>
   Good organization skills
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Preferred Qualifications
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Retail or Hospital experience
  </li>
  <li>
   Prior Authorization processing experience
  </li>
  <li>
   Claims processing experience
  </li>
  <li>
   Managed Care, Medicare, and/or Medicaid experience
  </li>
  <li>
   AS400 experience
  </li>
  <li>
   Proficiency in using computerized resources and software applications
  </li>
  <li>
   Proficiency with Microsoft applications (Excel, Word, and Outlook)
  </li>
  <li>
   Knowledge in pharmacy practices, procedures, and ability to read and understand clinical information
  </li>
  <li>
   Working knowledge of drug dosage forms, drug strength, generic and brand name equivalent.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Education
  <br/>
  <br/>
 </strong>
 High School diploma, G.E.D.
 <br/>
 <br/>
 <strong>
  Anticipated Weekly Hours
  <br/>
  <br/>
 </strong>
 40
 <br/>
 <br/>
 <strong>
  Time Type
  <br/>
  <br/>
 </strong>
 Full time
 <br/>
 <br/>
 <strong>
  Pay Range
  <br/>
  <br/>
 </strong>
 <strong>
  The Typical Pay Range For This Role Is
  <br/>
  <br/>
 </strong>
 $18.50 - $35.29
 <br/>
 <br/>
 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
 <br/>
 <br/>
 Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
 <br/>
 <br/>
 <strong>
  Great Benefits For Great People
  <br/>
  <br/>
 </strong>
 We take pride in our comprehensive and competitive mix of pay and benefits &ndash; investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
 <br/>
 <br/>
 <ul>
  <li>
   Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
  </li>
  <li>
   No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
  </li>
  <li>
   Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
   <br/>
   <br/>
  </li>
 </ul>
 For more information, visit https://jobs.cvshealth.com/us/en/benefits
 <br/>
 <br/>
 We anticipate the application window for this opening will close on: 03/21/2026
 <br/>
 <br/>
 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
</div>


Pharmacy Technician - Prior Authorization - Work From Home (9:30a-6p AZ/MST)

Onco360 Oncology Pharmacy

<div>
 <strong>
  Pharmacy Prior Authorization Specialist &ndash; Onco360 Pharmacy
  <br/>
  <br/>
 </strong>
 <em>
  Houston, TX
 </em>
 |
 <em>
  Full-Time
 </em>
 |
 <em>
  Starting at $23.00/hr and up
  <br/>
  <br/>
 </em>
 <strong>
  Join a mission-driven team making a difference in the lives of cancer patients.
  <br/>
  <br/>
 </strong>
 Onco360 Pharmacy is seeking a
 <strong>
  Pharmacy Prior Authorization Specialist
 </strong>
 to join our dedicated team in Houston, TX. This is a full-time position ideal for candidates local to the area.
 <strong>
  Remote work possible after initial on-site training.
  <br/>
  <br/>
 </strong>
 <strong>
  Company Benefits
  <br/>
  <br/>
 </strong>
 <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
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Why Join Us?
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   A career with purpose: Help patients access life-saving medications.
  </li>
  <li>
   Supportive culture: We value teamwork, respect, integrity, and passion.
  </li>
  <li>
   Growth opportunities: We invest in your professional and personal development.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  What You&rsquo;ll Do
  <br/>
  <br/>
 </strong>
 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.
 <br/>
 <br/>
 <strong>
  How You&rsquo;ll Do This
  <br/>
  <br/>
 </strong>
 <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.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  What You Bring
  <br/>
  <br/>
 </strong>
 <strong>
  Required:
  <br/>
  <br/>
 </strong>
 <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
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Preferred:
  <br/>
  <br/>
 </strong>
 <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
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Ready to make a meaningful impact? Apply today and help us better the lives of those battling cancer.
 </strong>
</div>


Pharmacy Prior Authorization Specialist

Onco360

<div><div><b>Pharmacy Prior Authorization Specialist &ndash; Onco360 Pharmacy</b><br>
<i>Buffalo, NY</i> | <i>Full-Time</i> | <i>Starting at $23.00/hr and up</i></div>
<div></div><div><b>Join a mission-driven team making a difference in the lives of cancer patients.</b></div>
<div></div><div>Onco360 Pharmacy is seeking a <b>Pharmacy Prior Authorization Specialist</b> 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.</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>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><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>
<div></div><div><b>#Company Values: Teamwork, Respect, Integrity, Passion</b></div></div>

<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 Waltham, MA. This is a full-time position ideal for candidates local to the area. Remote work possible after initial on-site training.</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>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><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>
<div></div><div><b>#Company Values: Teamwork, Respect, Integrity, Passion</b></div></div>

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