Prior Auth Support Specialist (Non-Clinical)
About The Position
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.
Requirements
- 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
- 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
Nice To Haves
- 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
- PTCB/CPhT strongly preferred (not required)
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.
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
- working with some of the smartest yet humblest and respectful people in the business
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
