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Specialty Medication Prior Authorization Specialist

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About us
**Job Summary:**

We are seeking a dedicated Prescription Navigator to join our healthcare team. Squad Health offers navigation services and software to patients of medical practices to remove barriers to treatment, particularly prescription access. Navigation services include prior authorizations, appeals, patient assistance enrollment, pharmacy coordination, patient education and engagement. Patient navigators will act as extensions of the providers we partner with, operating as delegates of their team.

**Duties:**

Verify benefits of patient’s insurance for review of drug and procedure orders

Obtain the appropriate authorization for services by completing authorization forms, while working with providers and their staff on unknown clinical questions:

  • Fill out clinical questions, including related diagnoses, based on medical notes and documentation
  • Fill out prescription questions based on prescription order and medication guidelines
  • Determine if additional clinical input is required prior to submission.
  • Check status of pending authorizations and continue to work these.
  • Complete appeals and letters of medical necessity.
  • Communicate with MD and NP’s if orders need to be changed on treatment plan or to discuss denials and request letter of medical necessity to appeal authorization denials

Work efficiently and collaboratively with other members of the benefits verification, prior authorization, pharmacy, patient engagement and product teams.

Participate in team meetings to problem solve patient issues, and improve company operations on behalf of patients and partner practices.

**Skills:**

  • 2 years experience submitting GI, rheumatology or urology medication prior authorizations required
  • Pharmacy technician preferred
  • Strong prescriber empathy and communication skills with patients, providers, insurances, pharmacies and other
  • Strong persistence and problem-solving skills; must be able to advocate for patient
  • High-school/GED required
  • Speak english fluently

This position offers the opportunity to make a meaningful impact on patients' lives while working in a collaborative healthcare environment. If you possess the required skills and are passionate about patient advocacy, we encourage you to apply for this rewarding role.

Job Type: Full-time

Pay: $20.00 - $25.00 per hour

Expected hours: 40 – 50 per week

Schedule:

  • Day shift
  • Monday to Friday

Application Question(s):

  • Please list 5 medications for which you have frequently completed prior authorizations and can discuss during an interview.
  • Have you worked in a hospital or doctor's office completing medication prior authorizations? If so, please elaborate what platforms you have used to submit these.

Work Location: Remote

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