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Prior Authorization Specialist (IN)

Squad Health
Remote

Quick apply

Job details

Full-time
₹70,000 - ₹99,000 a month

Qualifications

EHR systems
English

Full job description

Job description:

Pay: ₹70,000.00 - ₹105,000.00 per month

Prior Authorization Specialist (Prescription Navigator)

Remote | Offshore | Full-Time | EST Hours

Three options of working off-hours to choose from:

Weekdays | Work Hours 3:30 AM – 12:30 PM India Time (6:00 PM – 3:00 AM EST)

Weekdays | Work Hours 9:30 AM – 6:30 PM India Time (12:00 AM – 9:00 AM EST)

Weekends | Work Hours: 6:30 PM – 2:30 AM India Time (9:00 AM – 5:00 PM EST)

Compensation: $800– $1150 per month

Employment Type: Direct Hire | Full-Time

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 team members operate as extensions of provider offices, supporting clinical staff through accurate documentation and consistent follow-up.

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 team meetings to resolve patient access challenges and improve workflow

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 without supervision

Work Location: Remote

Job Type: Full-time

Pay: ₹70,000.00 - ₹99,000.00 per month

Application Question(s):

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
Why are you looking to leave (or have already left) your previous employer?
A summary of your relevant experience in United States-based prescriptions prior authorizations?

Work Location: Remote

Quick apply

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