What are the responsibilities and job description for the Prior Authorization Specialist position at Caremed?
Pharmacy Prior Authorization Specialist – CareMed Specialty Pharmacy
Waltham, MA | Full-Time | Starting at $23.00/hr and up
Waltham, MA | Full-Time | Starting at $23.00/hr and up
Sign-On Bonus: $5,000 for employees starting before August 31, 2026!
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.
Salary : $23