Prior Authorization Specialist

Prior Authorization Specialist CareMed Specialty Pharmacy - 2.9 Waltham, MA Job Details Full-time $23 - $28 an hour 21 hours ago Benefits Paid holidays Disability insurance Health insurance Dental insurance Tuition reimbursement Paid time off Vision insurance 401(k) matching Life insurance Referral program Qualifications Medicare Customer service High school diploma or GED Medicaid health insurance Registered Pharmacy Technician Medical claims submission Filing patient billing claims Medicaid Medical terminology Full Job Description Pharmacy Prior Authorization Specialist - CareMed Specialty Pharmacy Waltham, MA | Full-Time | Starting at $23.00/hr and up Join a mission-driven team making a difference in the lives of cancer and rare disease patients. CareMed Specialty Pharmacy is seeking a Pharmacy Prior Authorization Specialist 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. Company Benefits Medical; Dental; Vision 401k with a match Paid Time Off and Paid Holidays Tuition Reimbursement Quarterly Incentive Bonus Paid Volunteer Day Referral Incentive Program Company Paid Life Insurance; and Short/Long-Term Disability 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. What You'll Do 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.

What You Bring Required:

High School Diploma or GED 1+ years of pharmacy or prior authorization experience 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

CoverMyMeds Preferred:

Associate degree or Certified Pharmacy Technician (PTCB) 3+ years of experience in pharmacy or prior authorizations Specialty pharmacy experience Ready to make a meaningful impact? Apply today and help us better the lives of those battling cancer.