See all roles

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

Work from home Full-time role Hiring

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 like

Health Coach Diabetes Care Team

Work from home Full-time role

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

Work from home Full-time role

Virtual Medical Scribe

Work from home Full-time role

Remote Medical Assistant- Healthguide -Bilingual Hindi Speaking

Work from home Full-time role

Integration Engineer, Hospital Patient Monitoring – East Zone

Work from home Full-time role

Principal Pharmacovigilance Specialist, Case Processing

Work from home Full-time role

Litigation Insurance Adjuster (Remote)

Work from home Full-time role

Commercial Property Claims Desk Adjuster - Remote after training

Work from home Full-time role

Independent Insurance Claims Adjuster in Clarksville, Tennessee

Work from home Full-time role

Commercial Real Estate Lawyer Assistant (Remote)

Work from home Full-time role

Experienced Data Entry Specialist – Virtual Remote Position at arenaflex

Work from home Full-time role

Experienced Customer Service Representative – Remote Opportunity with arenaflex

Work from home Full-time role

Product Manager, R&D

Work from home Full-time role

Venue Sales Representative – Sports & Entertainment (Remote, West Coast)

Work from home Full-time role

PRN Family/Internal Medicine Physician

Work from home Full-time role

APTPUO – Automne 2026 – EDU 5642 - DA00 - Courants en didactique des langues secondes

Work from home Full-time role

Customer Service (remote work , no vaccination required)

Work from home Full-time role

Experienced Data Entry Specialist – Remote Opportunity at arenaflex

Work from home Full-time role

Experienced Customer Relations Chat Agent – Remote Opportunity with arenaflex

Work from home Full-time role

Fully 100% Remote Special Education Teacher (Mild-Mod)

Work from home Full-time role