Prior Auth Support Specialist (Non-Clinical) at PrescriberPoint

, , United States -

Full Time

Start Date

Immediate

Expiry Date

13 Jun, 26

Salary

85000.0

Posted On

15 Mar, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Prior Authorization Workflows, Benefit Verification, Pbm Requirements, Documentation, Referral Coordination, Hcp Support, Case Tracking, Hipaa Compliance, Provider Office Communication, Hubspot, Workflow Management, Coverage Criteria, Authorization Documentation, Loop Closure, Operational Support

Industry

Software Development

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)! 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. Who We Are Looking For We are looking for a rare but specific professional who lives and breathes prior authorization workflows. You come from one of two backgrounds: Lane 1 — Hospital or Clinic Central Authorization You have worked inside a hospital, health system, or clinic in a central authorization or referral coordination function — not a call center, not a general admin role. You have processed prior authorizations and referrals from the provider office side, understand how both medical and pharmacy benefits work at the workflow level, and have navigated payers, PBMs, and documentation loops without clinical oversight. Lane 2 — Pharmacy Technician with PA Specialization You are an entry to mid-level pharmacy technician whose work has been focused on prior authorizations, insurance, and PBM requirements — not retail dispensing or compounding. You understand coverage criteria, benefit verification, authorization documentation, and payer communication. You are comfortable working in a back office, HCP-supportive environment. If neither lane describes your background, this role is likely not a match. Important: This Is Not a Patient-Facing Role This position exists to support Healthcare Providers (HCPs) and their office staff — not patients directly. You will work with provider office teams, referral coordinators, and authorization staff to move PA workflows forward on the provider side. About the Role 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. Schedule Training (first 20 business days): Monday–Friday, 11:00am–8:00pm ET Post-training: Standard EST hours with occasional flexibility as coverage needs evolve Must-Have Qualifications You will not be considered without the following: 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 Core Responsibilities 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 Highly Valued PTCB/CPhT certification Pharmacy technician background with dedicated PA and insurance specialization Experience with specialty workflows and complex payer back-and-forth HubSpot or comparable CRM workflow tool experience Hospital or clinic central authorization experience supporting provider offices across benefits, PA, and documentation workflows What Success Looks Like — First 90 Days Operating independently in core PA and referral workflows with minimal direction Consistently identifying next steps, removing blockers, and preventing case stalls Clean, timely documentation in HubSpot so activity is easy to follow and report Effective provider office communication — navigating gatekeepers and workflows to move cases forward Appropriate escalation with full context so clinical teams can act efficiently Contributing process feedback that strengthens SOPs and reduces recurring friction Education High school diploma or GED required PTCB/CPhT strongly preferred 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

The role involves executing end-to-end prior authorization and referral workflows, focusing on documentation follow-up, routing, and closing loops with provider offices. Responsibilities also include communicating with provider staff, supporting clinical teams by gathering missing documentation, and maintaining accurate records in tracking tools.