Prior Authorization Support Specialist

Administrative AssistantAdministrative AssistantFull TimeRemoteTeam 11-50

Location

United States

Posted

2 days ago

Salary

$70K - $85K / year

Prior AuthorizationMedical BenefitsPharmacy BenefitsPBM RequirementsHIPAA ComplianceCase DocumentationProvider CommunicationInsurance VerificationWorkflow ExecutionHub Spot

Job Description

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

Hello! Please note that unless you can accommodate some unusual hours (with a cheery demeanor), this role is best-suited for those living in the Eastern Standard Timezone. 100% Remote. Must be performed in the States. Sadly, we cannot facilitate VISAs. Cover letters are welcomed, appreciated, and reviewed (by a human)!

This role supports provider offices, internal operations, and clinical teams by driving the execution layer of prior authorization and referral workflows. The focus is purely operational: documentation requirements, follow-up, routing, and closing loops so work progresses without delay. This role is for someone who can ramp into complex workflows, manage multiple active workstreams, and deliver consistent outcomes with minimal oversight.

Qualifications

  • 5+ years of hands-on prior authorization experience — beyond general call center or data entry work
  • Direct experience in either a hospital/clinic central authorization function OR pharmacy technician role with dedicated PA and insurance specialization
  • Demonstrated understanding of both medical and pharmacy benefit PA workflows at the documentation and execution level
  • Experience navigating PBM requirements including coverage criteria, benefit verification, and authorization documentation standards
  • Proven ability to communicate with provider offices via phone and email — navigating gatekeepers, call trees, and office workflows to move documentation forward
  • Strong documentation discipline: accurate, timely case tracking with notes, outcomes, timestamps, and next steps
  • HIPAA compliance knowledge and scope discipline
  • Eastern Time Zone — non-negotiable

Requirements

  • Execute PA and referral workflows end-to-end: documentation follow-up, routing, and loop closure with provider offices
  • Drive work forward by identifying next steps, obtaining missing information, and preventing case stalls
  • Communicate clearly and professionally with provider office staff via phone and email
  • Support clinical teams by reducing administrative burden — gather missing documentation, route questions appropriately
  • Maintain accurate, timely documentation in HubSpot and operational tracking tools
  • Identify recurring friction points and contribute actionable feedback to strengthen SOPs
  • Operate strictly within scope — workflow, documentation, process, and follow-up only

Benefits

  • Salary ranges from $70-85k based on experience and location
  • 401(k) w/matching
  • All kinds of insurance (including matching HSA and pets!)
  • Open PTO (which leaders use!)
  • Remote stipend
  • Yearly education budget
  • Working with some of the smartest yet humblest and respectful people in the business

Education

  • High school diploma or GED required
  • PTCB/CPhT strongly preferred

Job Requirements

  • 5+ years of hands-on prior authorization experience — beyond general call center or data entry work
  • Direct experience in either a hospital/clinic central authorization function OR pharmacy technician role with dedicated PA and insurance specialization
  • Demonstrated understanding of both medical and pharmacy benefit PA workflows at the documentation and execution level
  • Experience navigating PBM requirements including coverage criteria, benefit verification, and authorization documentation standards
  • Proven ability to communicate with provider offices via phone and email — navigating gatekeepers, call trees, and office workflows to move documentation forward
  • Strong documentation discipline: accurate, timely case tracking with notes, outcomes, timestamps, and next steps
  • HIPAA compliance knowledge and scope discipline
  • Eastern Time Zone — non-negotiable
  • Execute PA and referral workflows end-to-end: documentation follow-up, routing, and loop closure with provider offices
  • Drive work forward by identifying next steps, obtaining missing information, and preventing case stalls
  • Communicate clearly and professionally with provider office staff via phone and email
  • Support clinical teams by reducing administrative burden — gather missing documentation, route questions appropriately
  • Maintain accurate, timely documentation in HubSpot and operational tracking tools
  • Identify recurring friction points and contribute actionable feedback to strengthen SOPs
  • Operate strictly within scope — workflow, documentation, process, and follow-up only

Benefits

  • Salary ranges from $70-85k based on experience and location
  • 401(k) w/matching
  • All kinds of insurance (including matching HSA and pets!)
  • Open PTO (which leaders use!)
  • Remote stipend
  • Yearly education budget
  • Working with some of the smartest yet humblest and respectful people in the business
  • Education
  • High school diploma or GED required
  • PTCB/CPhT strongly preferred

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