Prior Authorization Specialist

Pharmacy Prior Authorization Specialist – CareMed Specialty Pharmacy

Houston, TX| Full-Time | Starting at $23.00/hr and up

Join a mission-driven team making a difference in the lives of cancer patients.

CareMed Specialty Pharmacy is seeking a Pharmacy Prior Authorization Specialist to join our dedicated team in Houston, TX. 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.
  
  

Required

What You Bring

• 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.

Company Values: Teamwork, Respect, Integrity, Passion