Manage pharmacy prior authorization requests and appeals with insurance carriers, including resolving rejected claims so patients can access prescribed medications. Coordinate with physicians, pharmacists, and other departments while maintaining HIPAA-compliant records and monitoring authorizations for renewal. Requires a high school diploma or GED, at least one year of pharmacy or prior authorization experience, and state Board of Pharmacy registration where required. Candidates should have knowledge of pharmacy terminology, insurance claims, Medicare and Medicaid, claim rejection resolution, coordination of benefits, NDC billing, and CoverMyMeds; an associate degree or PTCB certification and specialty pharmacy experience are preferred.
Onco360 provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
