Prior Auth Support Specialist (Non-Clinical)

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.