-
-
TYPE OF WORK
Full Time
-
-
WAGE / SALARY
$800-$1000
-
-
HOURS PER WEEK
40
-
-
DATE UPDATED
Apr 8, 2026
About Us
Squad Health provides navigation services and software to US medical practices to remove barriers to treatment — especially prescription access.
Our services include benefits investigation, prior authorization submission, patient assistance enrollment, pharmacy coordination, and patient engagement.
Our tea
Job Summary
We are seeking an experienced Prior Authorization Specialist with strong background in US specialty medication authorizations. This role requires reviewing clinical documentation, verifying insurance benefits, submitting medication authorizations, and managing denials and appeals efficiently.
Duties
Verify insurance benefits for drug and procedure orders (Commercial, Medicare, Medicaid)
Determine pharmacy vs. medical benefit requirements when applicable
Obtain appropriate authorizations by completing payer-specific forms and clinical questionnaires
Review medical notes, diagnosis information, and treatment history to answer clinical questions accurately
Submit and manage authorizations through, payer portals, fax, or phone
Track pending authorizations and follow up until resolution
Prioritize and manage STAT/urgent requests appropriately
Communicate with MDs and NPs regarding denials, treatment plan updates, and Letters of Medical Necessity (LMNs)
Assist patients with copay assistance or patient assistance programs when needed
Enroll patients into navigation programs and obtain consent
Document all actions clearly in internal systems and case trackers
Participate in tea
Required Skills & Experience
Minimum 2 years of US-based specialty medication prior authorization experience
Experience managing other PA Specialists preferred
Direct experience supporting GI, Dermatology, Rheumatology, Urology and Allergy medication authorizations required
Strong understanding of US insurance plans (Commercial, Medicare, Medicaid)
Experience reviewing EMR/EHR clinical documentation
Strong attention to detail and structured documentation habits
Fluent English (written and verbal)
Ability to work full-time night shift aligned with EST hours
To apply:
Subject: Prior Authorization Specialist
Answer these questions in your message:
1. A summary of your relevant experience in United States-based prior authorizations?
2. List 5 medications for which you have frequently completed prior authorizations and can discuss during an interview?
3. 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
4. Why are you looking to leave (or have already left) your previous employer?
5. Send a copy of your resume
No answers for those 5 questions will not be considered.
