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TYPE OF WORK
Full Time
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SALARY
$800-$1000
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HOURS PER WEEK
40
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DATE UPDATED
Jul 29, 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 & Medical Benefits Specialist with a strong background in US specialty medication authorizations, including buy-and-bill, infusion, biologic, and clinic-administered medications. This role requires reviewing clinical documentation, verifying medical and pharmacy benefits, submitting medication authorizations, and managing denials and appeals efficiently. This is a fully offshore/remote position, but candidates should have direct, hands-on experience working with US healthcare practices (clinic, infusion center, specialty practice, or buy-and-bill team).
Duties
Verify insurance benefits for drug and procedure orders (Commercial, Medicare, Medicaid)
Complete medical benefits investigations for buy-and-bill, infusion, biologic, injectable, and clinic-administered medications
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
Obtain appropriate authorizations by completing payer-specific forms and clinical questionnaires
Submit and manage authorizations through, payer portals, fax, or phone
Prioritize and manage STAT/urgent requests appropriately
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 authorizations, buy-and-bill, infusion, biologic, or clinic-administered medications
Experience managing a team of buy and bill specialists preferred
Direct experience supporting GI, Dermatology, Rheumatology, Allergy, Oncology, or Urology 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 without supervision
Ability to work US daytime hours
Application Question(s):
A summary of your relevant experience with US-based buy-and-bill prior authorizations and medical benefits investigations?
List 5 infusion, biologic, or clinic-administered medications for which you have frequently completed buy-and-bill prior authorizations and can discuss during an interview?
Have you worked in a clinic, infusion center, or specialty practice completing buy-and-bill prior authorizations? If so, please elaborate on what payer portals or platforms you used to submit these and verify medical benefits
Why are you looking to leave (or have already left) your previous employer?
Work Location: Remote
Job Type: Full-time
