All jobs

Prior Authorization Specialist, Data Extraction & AI Quality (Fully Remote, Part-Time)

100% Remote Full-time Open now

Prior Authorization Specialist, Data Extraction & AI Quality (Fully Remote, Part-Time) Rate: $30–$60/hour (depending on experience) Schedule: Part-time, fully remote Company: Quantile Health – AI-Powered Insights for Life Science Quantile Health is a New York-based, fast growing AI agent startup on a mission to expand patient access to life-changing medicines while cutting commercial research costs for the life science industry.

About the Role

We’re seeking a part-time Prior Authorization (PA) specialist to work with our AI research teams to improve our access agent. This role focuses on identifying patient access 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. Our Interview Process

  • Take-Home Exercise (30–45 minutes): You’ll complete a short classification task with instructions. We’ll evaluate it based on speed and accuracy.
  • Conversation (30-minute Google Meet): If selected, you’ll meet with one of our AI researchers to walk through your approach and findings, and answer any of your questions

Responsibilities

  • 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

Required Qualifications

  • 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

Preferred Qualifications

  • PharmD
  • Prior responsibility for PA interpretation or benefit determinations
  • Experience training or QA’ing other reviewers

How We Work

  • Fully remote and async-friendly, with the flexibility to work weekends or outside of standard 9–5 hours whenever it fits your schedule.
  • Accuracy and turnaround time tracked internally
  • All communication via Slack

Apply tot his job Apply To this Job

You might also like

Health Coach Diabetes Care Team

100% Remote Full-time

Virtual Medical Scribe |Internal Medicine| Multiple Shift Times (Central Standard Time) | Weekdays

100% Remote Full-time

Virtual Medical Scribe

100% Remote Full-time

Remote Medical Assistant- Healthguide -Bilingual Hindi Speaking

100% Remote Full-time

Integration Engineer, Hospital Patient Monitoring – East Zone

100% Remote Full-time

Litigation Insurance Adjuster (Remote)

100% Remote Full-time

Commercial Property Claims Desk Adjuster - Remote after training

100% Remote Full-time

Independent Insurance Claims Adjuster in Clarksville, Tennessee

100% Remote Full-time

Commercial Real Estate Lawyer Assistant (Remote)

100% Remote Full-time

Entry Level Mortgage Loan Processor

100% Remote Full-time

Experienced Customer Service Representative – Walmart Support Specialist (Entry Level) Remote

100% Remote Full-time

Remote/ DOD / Physician - Flight Surgeon

100% Remote Full-time

Senior Product Designer

100% Remote Full-time

Automation Tester- REMOTE

100% Remote Full-time

Account Executive, SaaS Public Sector (ERP Financial Software) REMOTE

100% Remote Full-time

Grants Management Project Manager, Business Analyst

100% Remote Full-time

Experienced Customer Support Associate – Remote Opportunity with arenaflex

100% Remote Full-time

Part Time Evening Remote Data Entry Specialist – Unlock Your Potential with arenaflex

100% Remote Full-time

Senior Mainframe Developer

100% Remote Full-time

Experienced Part-Time Remote Data Entry Specialist – Amazon Cloud Computing and E-commerce

100% Remote Full-time