Quantile Health

Making transformative medicine accessible to every patient

Prior Authorization Specialist, Data Extraction – AI Quality

Artificial IntelligenceArtificial IntelligencePart TimeRemoteTeam 11-50Since 2022Company SiteLinkedIn

Location

United States

Posted

19 days ago

Salary

$45 / hour

Bachelor Degree1 yr expEnglish

Job Description

• Review payer PA policy documents for specialty medications. Interpret coverage criteria including: Step therapy sequences, Prescriber and site-of-care restrictions etc • Translate policy language into standardized, structured data fields • Flag ambiguous, conflicting, or unclear policy language • Maintain high accuracy and consistency across large document batches • Communicate edge cases and clarifications via Slack

Job Requirements

  • Bachelors degree, Masters degree in Pharmacy, Pharmacy intern, or PharmD student
  • 1+ years of direct experience interpreting PA requirements in:
  • Specialty pharmacy
  • Hub services
  • Utilization management teams within 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, structured work

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