Prior Auth Support Specialist (Non-Clinical) at PrescriberPoint

, , United States -

Full Time

Start Date

Immediate

Expiry Date

04 Jun, 26

Salary

85000.0

Posted On

06 Mar, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Prior Authorization, Referral Workflows, Documentation Follow-up, Workflow Coordination, Process Improvement, HubSpot, CRM Tooling, Professional Communication, Operational Ownership, Follow-up Discipline, Process-Oriented Problem Solving, Scope Discipline, Escalation Management, Payer Requirements, Benefits Verification, Access Support

Industry

Software Development

Description

100% Remote. Must be performed in the States. Sadly, we cannot facilitate VISAs. Cover letters are welcomed, appreciated, and reviewed (by a human)! Unless you can accommodate some unusual hours (with a cheery demeanor), this role is best-suited for those living in the Eastern Standard Timezone. About PrescriberPoint: The brainchild of David Ricks, CEO of Lilly, and incubated by Boston Consulting Group’s Digital Ventures, PrescriberPoint is a Series A healthtech whose mission is to help Health Care Professionals reduce the time, tension, and anxieties they and their patients encounter during the prescribing process. We are funded to date by Lilly, Pfizer, Adobe, and MasterCard. Role Summary This role supports provider offices, internal operations, and clinical teams by driving the execution layer of prior authorization (PA) and referral workflows. The focus is operational: documentation requirements, follow-up, routing, and closing loops so work progresses reliably. This is a non-clinical role suited for someone who can ramp into complex workflows, manage multiple active workstreams, and deliver consistent outcomes with limited oversight. Schedule / Coverage Training schedule (first 20 business days): Monday–Friday, 11:00am–8:00pm Eastern Time (ET) (aligned with manager’s hours) Post-training schedule (after 20 business days): Schedule will adjust to a standard EST start and end time, with some occasional flexibility required based on coverage needs Core Responsibilities Execute PA/referral workflows with provider offices, including process coordination, documentation follow-up, and appropriate routing. Drive work forward by identifying next steps, obtaining missing information, closing loops, and preventing workflow delays. Communicate with provider offices (PA/referrals staff, office managers, and workflow owners) in a clear, professional, non-clinical manner via phone and email. Support clinical teams by reducing administrative burden: gather missing documentation, route questions appropriately, and ensure clinical staff receives only items requiring clinical input. Maintain accurate, timely documentation and tracking in operational tools (e.g., HubSpot/trackers), including notes, outcomes, timestamps, and next steps. Reinforce adoption of PrescriberPoint workflows and tools by helping provider offices follow process and stay on track. Identify recurring issues (documentation gaps, payer back-and-forth, workflow breakdowns) and provide actionable feedback internally. Contribute to maintaining and improving SOPs/playbooks as workflows evolve. Qualifications Relevant Background (one or more preferred) Candidates typically come from one or more of the following (or a closely related equivalent): Prior Authorization (PA) Coordinator / Referral Coordinator Patient Support Representative (PSR) in a hub/patient services setting Benefits Verification / Access Support / Reimbursement Support Specialty or high-touch access support role (non-clinical, execution-focused) Education & Experience High school diploma or GED required 5+ years of hands-on experience managing high-touch, multi-step PA/referrals workflows (beyond basic call center work) Demonstrated experience with pharmacy benefits / PBM-driven requirements at the workflow level (documentation collection, criteria gathering, follow-up, routing) Experience supporting provider offices directly via phone/email, including navigating gatekeepers, call trees, and internal office workflows to move documentation/forms/records through the process PTCB/CPhT strongly preferred (not required) Core Competencies (Qualifications) Demonstrated ownership of operational outcomes (e.g., consistently progressing work without waiting for step-by-step direction) Strong follow-up discipline and organization across multiple concurrent workflows, with consistent tracking and close-loop execution Clear, professional communication via phone and email, with appropriate persistence Process-oriented problem solving: ability to identify where work is stalled and take action to remove blockers Scope discipline: operates strictly within a non-clinical scope (workflow, documentation, process, follow-up); does not provide clinical advice or make clinical determinations Comfortable working within a tiered support structure: resolves what can be handled at this level, escalates appropriately with clear context when needed, and keeps execution moving Highly Valued Pharmacy technician background and/or deep PA/referrals experience in a high-touch environment Experience with specialty workflows, complex payer back-and-forth, and repeated documentation loops Hospital or specialty authorization/referral experience supporting provider offices across benefits, PA, and documentation workflows HubSpot and/or comparable CRM/workflow tooling experience Proven ability to support clinical teams operationally while maintaining clear non-clinical boundaries What Success Looks Like (First 90 Days) By the end of the first 90 days, this hire is operating independently in our core prior authorization (PA) and referral workflows, supporting provider offices with clear, non-clinical guidance and keeping work moving without constant oversight. Success includes: Independent execution: Manages day-to-day PA/referral workflows end-to-end (documentation follow-up, routing, close-loop communication) with minimal direction. Strong workflow ownership: Consistently identifies the next step, removes blockers, and prevents cases from stalling—while staying within a non-clinical scope. Provider office support: Communicates clearly and professionally with provider offices by phone and email, effectively navigating gatekeepers, call trees, and office workflows to obtain required items. Operational discipline: Maintains clean, timely documentation in HubSpot/trackers (notes, outcomes, timestamps, next steps) so activity is easy to follow and report. Appropriate escalation: Resolves what can be handled at their level and escalates only when needed, providing clear context so clinical or internal teams can respond efficiently. Process contribution: Identifies repeat friction points (missing documentation, payer back-and-forth, workflow breakdowns) and shares actionable feedback to strengthen SOPs and improve execution over time. Coverage readiness: Able to support East Coast coverage needs confidently within the scheduled window and contribute to consistent service levels for the team. Compensation Salary ranges from $70-85k based on experience and location. So, why (on earth!) would you want to leave what you’re doing and join us? We have a really good shot at improving the millions of lives and careers of HCPs, Patients, and their families (even pets!) We hire adults with a Trust-first/It's All Life philosophy We have some great benefits for a firm at our stage: 401(k) w/matching, all kinds of insurance (including matching HSA and pets!), commute from your kitchen, Open PTO (which leaders use!), remote stipend, yearly education budget, and working with some of the smartest yet humblest and respectful people in the business We’re (objectively) way better looking than our competitors :-) Beliefs: PrescriberPoint is an equal opportunity employer that is committed to inclusion and diversity. We take affirmative action to ensure equal opportunity for all applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, status as a qualified individual with a disability, veteran status, or other legally protected characteristics. Learn more about your EEO rights as an applicant. Additionally, we participate in the E-Verify program as required by applicable law. Learn more about E-Verify here. Last, PrescriberPoint is a drug-free workplace committed to maintaining a safe workplace free from unlawful drugs and alcohol and complies with all applicable laws, including the Federal Drug-Free Workplace Act. Team members are prohibited from reporting to work or performing their duties with any unlawful drugs or alcohol in their system. They are also prohibited from using, possessing, manufacturing, selling, trading, distributing, dispensing or making arrangements or offering to distribute unlawful drugs or alcohol while at work or performing work duties. Any violation of the Company’s drug-free workplace policy may result in disciplinary action, up to and including disqualification from employment or termination, unless otherwise allowed by law.

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Responsibilities

This role supports provider offices and internal teams by executing prior authorization and referral workflows, focusing on documentation requirements, follow-up, routing, and closing loops to ensure reliable work progression. Key duties include communicating with provider offices, gathering missing documentation for clinical teams, maintaining accurate tracking in operational tools, and identifying recurring workflow issues.