Pharmacy Prior Authorization Specialist
Onco360, Inc. - Buffalo, New York, United States, 14266
Work at Onco360, Inc.
Overview
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Overview
Pharmacy Prior Authorization Specialist
role at
Onco360 Oncology Pharmacy . Come join our company! Our Onco360 Pharmacy has an immediate need for Pharmacy Prior Authorization Specialists in
Buffalo, NY ! Seeking candidates who live local to this pharmacy location. Full-time
Monday-Friday 10:30-7 or 11:30-8 . Along with our benefits, we offer quarterly incentive bonuses. A career with us is more than just a job. It’s an opportunity to connect and care for our patients, providers, communities, and each other. We attract extraordinary people who have a strong desire to live our mission – to better the lives of those battling cancer and rare diseases. Compassion is more important than numbers. We value teamwork, respect, integrity, and passion. We succeed when you do, and our company and management team work hard to foster an environment that provides you with opportunities for both professional and personal growth. Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers. Starting at
$23.00 and up . We offer a variety of benefits including: Medical; Dental; Vision 401k with a match Paid Time Off and Paid Holidays Tuition Reimbursement Company paid benefits – life; and short and 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. Primary Responsibilities: Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed. Follow prior authorization workflow and policies and procedures. Collaborate with other departments to assist in obtaining prior authorizations. Review accuracy and completeness of information requested and ensure all supporting documents are present. Receive requests for prior authorizations and ensure they are properly monitored. Consult with supervisor or pharmacist to confirm treatment appropriateness. Process referrals and submit clinical supporting documentation to insurance carriers. Manage correspondence with insurance companies, physicians, and patients. Review denials and submit appeals if requested by physicians. Document all prior authorization information, including approval dates and numbers. Proactively work on prior authorizations nearing expiration. Secure patient information respecting HIPAA regulations. Qualifications: Good interpersonal, verbal, written, and customer service skills. Ability to work independently, meet deadlines, and be flexible. Good organizational and detail-oriented skills. Knowledge of medical terminology, pharmacy terminology, and medication names. Licensed/registered pharmacy technician as per state law. Basic math and analytical skills, intermediate typing skills. Education & Experience: Required: High School Diploma or GED, previous pharmacy and prior authorization experience. Desired: Associate degree, Certified Pharmacy Technician, or specialty pharmacy experience. Work Experience: Required: 1+ years pharmacy or prior authorization experience. Desired: 3+ years pharmacy or prior authorization experience. Licenses & Certifications: Required: State law registration with the Board of Pharmacy. Desired: Certified Pharmacy Technician (PTCB). Behavior Competencies: Independent worker, good interpersonal skills, excellent communication skills, detail-oriented, time management.
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