Prior Auth Support Specialist (Non-Clinical)

About the position

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.

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

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
• High school diploma or GED required

Nice-to-haves
• 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
• PTCB/CPhT strongly preferred

Benefits
• 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

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