Remote Prior Authorization Specialist - Pharmacy Support

phil; United States; Remote; USD 55,000 - 75,000; Full time

Benefits offered by this job

Ground floor startup

Fully remote in multiple states

Remote processing support

Job summary

PHIL is a San Francisco-based health-tech startup seeking a full-time Prior Authorization Specialist to support pharmacy operations. The role focuses on ensuring timely electronic prior authorizations and provides phone/email support to prescribing offices.

Responsibilities include verifying insurance coverage, submitting authorizations, troubleshooting submissions, and assisting with appeals. Remote processing is available, with in-office options where required, across multiple states.

Qualifications

• Proven experience in prior authorizations or medical insurance billing.
• Strong written and verbal communication skills.
• Ability to adapt to new systems and workflows.

Responsibilities

• Verify patient insurance coverage
• Submit prior authorizations via electronic portal
• Troubleshoot submissions with providers
• Assist providers with appeals processing
• Ensure documentation is accurate for submission
• Track trends in determinations for education
• Document activities in the operating system
• Collaborate with Customer Support to support patients

Skills

Team player

Written & verbal communication

Adapt to new system

Prior authorizations/insurance billing

ICD-10 knowledge

Multi-system navigation

Customer service

Reliable internet

Tools

Electronic portals

Job description

PHIL is a San Francisco-based health-tech startup seeking a full-time Prior Authorization Specialist to support pharmacy operations. The role focuses on ensuring timely electronic prior authorizations and provides phone/email support to prescribing offices.

Responsibilities include verifying insurance coverage, submitting authorizations, troubleshooting submissions, and assisting with appeals. Remote processing is available, with in-office options where required, across multiple states.