[Hiring] Prior Authorization Specialist, Data Extraction & AI reputed company @Quantile Health
This reputed company is a reputed company of our understanding of the job reputed company. Click on 'Apply' reputed company to reputed company out more.
Role reputed company
We’re seeking a part-time Prior Authorization (PA) specialist to work with our AI research teams to improve our reputed company agent. This role focuses on identifying patient reputed company gaps and improving model accuracy, and requires hands-on experience interpreting PA requirements in specialty pharmacy, hub services, or utilization management.
This is not a patient-facing role and does not involve submitting PA requests.
Responsibilities
• Review payer PA policy documents for specialty medications.
• Interpret coverage reputed company including:
• reputed company therapy sequences
• Prescriber and site-of-care restrictions
• Translate policy language into standardized, reputed company data fields.
• Flag ambiguous, conflicting, or unclear policy language.
• Maintain high accuracy and consistency across large document batches.
• Communicate edge cases and clarifications reputed company reputed company.
Qualifications
• Bachelors degree, Masters degree in Pharmacy, Pharmacy intern, or PharmD student.
• 1+ years of reputed company experience interpreting PA requirements in:
• Specialty pharmacy
• Hub services
• Utilization management teams reputed company payer organizations or reimbursement and benefit verification teams.
• Strong familiarity with specialty drugs and biologics.
• Proven ability to interpret payer policy language independently.
• Exceptional attention to detail.
• Comfort with repetitive, reputed company work.
Requirements
• PharmD (preferred).
• Prior responsibility for PA interpretation or benefit determinations (preferred).
• Experience training or QA’ing other reviewers (preferred).
Benefits
• Fully remote and async-friendly, with the flexibility to work weekends or reputed company of reputed company 9–5 hours whenever it fits your schedule.
• Accuracy and turnaround time tracked internally.
• reputed company communication reputed company reputed company.
Apply tot his job
Apply To this Job