Prior Authorization Specialist - Remote ID-9659
About Capsule
Capsule is a new kind of pharmacy. One that is smarter, friendlier, faster, and hand-delivers your medication, same-day, for free. We have a national presence and have raised over $500MM from the best healthcare and technology investors in the world. People succeed in our culture when they are intensely focused on our customers, are energized by accomplishing ambitious goals, and push themselves and their teammates to be their best. If this excites you, we'd love to have you join us.
The ClearRx team at Capsule powers a product designed to streamline and enhance the pharmacy experience for providers and their patients. ClearRx seamlessly supports any pharmacy, any prescription, and any location.
About the Role
As an insurance specialist on the ClearRx team, you will be responsible for providing white-glove service for ClearRx customers by following an efficient prescription workflow, optimizing customer satisfaction, and helping to navigate complex pharmacy issues.
Your responsibilities will include:
Virtual Assistant, $45/hr, Remote, No Experience, Night Job
Entry-Level Remote Data Entry, $50/hr, Evening Job
Customer Support, No Degree, $40/hr, Remote, Weekend Job
Remote Phone Job, $42/hr, Part-Time, College Student Friendly
Virtual Assistant, $40/hr, Remote, No Degree, Night Job
Part-Time Data Entry, $45/hr, Remote, College Student Friendly
Remote Moderator, No Degree, $50/hr, Evening, Weekend Job
Remote Customer Support, $42/hr, Night Job, No Experience
Live Chat Support, $40/hr, Remote, Entry Level, Part-Time
Virtual Assistant, Remote, $42/hr, Weekend, No Experience
Remote Data Entry, $45/hr, No Degree, Night Shift
Part-Time Customer Support, $40/hr, Remote, College Student
Remote Live Chat, $50/hr, Part-Time, Evening/Night Job
Entry Level Phone Job, $42/hr, Remote, No Degree Required
Weekend Data Entry, $45/hr, Remote, No Experience
Remote Virtual Assistant, $40/hr, Evening, Part-Time Job
Remote Moderator, $42/hr, Part-Time, Weekend, No Degree
Data Entry, $45/hr, Remote, Night Shift, College Student Job
Phone Support, Remote, $50/hr, No Experience, Part-Time
Virtual Assistant, No Experience, $42/hr, Remote, Weekend
Remote Customer Support, $45/hr, Part-Time, College Student
Data Entry, Remote, $40/hr, Night Shift, No Degree
Evening Virtual Assistant, Remote, $45/hr, No Experience
Weekend Customer Support, $42/hr, Remote, College Student
Remote Data Entry, $50/hr, No Experience, Evening/Night Job
Remote Live Chat, $40/hr, Part-Time, No Degree Required
Virtual Assistant, $42/hr, Remote, Weekend, Entry Level
Remote Phone Support, $45/hr, Evening, No Experience Required
Data Entry, No Experience, $50/hr, Remote, College Student
Remote Moderator, $40/hr, Weekend, No Degree, Part-Time
Live Chat Support, Remote, $42/hr, Night Shift, College Student
Phone Job, $50/hr, Remote, No Degree, Part-Time, Weekend
Data Entry, $45/hr, Remote, Evening, No Experience Required
Virtual Assistant, No Experience, $42/hr, Remote, Part-Time
Remote Customer Support, $50/hr, Night Shift, No Degree
Remote Data Entry, $40/hr, College Student Friendly, Part-Time
Live Chat Support, $42/hr, Weekend, Remote, No Degree
Virtual Assistant, Remote, $45/hr, Evening, No Experience
Remote Phone Job, $50/hr, College Student, Night Shift
Remote Moderator, $42/hr, Weekend, No Experience Required
Data Entry, No Degree, $45/hr, Part-Time, Remote Job
Customer Support, $50/hr, Remote, Evening/Night Job, No Degree
Virtual Assistant, $42/hr, Remote, Weekend, No Degree
Remote Live Chat, $45/hr, College Student, No Experience
Remote Data Entry, $40/hr, Part-Time, No Degree Required
Phone Support, $50/hr, Weekend, Remote, No Experience
Virtual Assistant, $42/hr, Evening, Remote, No Degree
Remote Customer Support, $45/hr, No Experience, Part-Time
Data Entry, $50/hr, Night Job, No Degree, Remote
Remote Moderator, $40/hr, College Student Friendly, Part-Time
Virtual Assistant, Remote, $42/hr, Weekend, No Experience
Remote Phone Job, $45/hr, Part-Time, No Degree Required
Customer Support, $50/hr, Night Job, Remote, No Experience
Data Entry, Remote, $42/hr, Evening Job, No Degree
Live Chat Support, $45/hr, Weekend, Remote, College Student
Virtual Assistant, Remote, $50/hr, Part-Time, Night Shift
Data Entry, $40/hr, No Experience, Remote, Weekend Job
Remote Phone Job, $45/hr, No Degree, College Student Friendly
Customer Support, $42/hr, Remote, Evening, No Experience
Virtual Assistant, $50/hr, Weekend, No Degree, Remote
Remote Data Entry, $40/hr, Part-Time, College Student Job
Phone Support, Remote, $42/hr, Evening/Night Shift
Virtual Assistant, No Degree, $45/hr, Remote, Part-Time
Live Chat Support, $50/hr, Remote, No Experience Required
Remote Moderator, $42/hr, College Student, Weekend Job
Data Entry, $45/hr, Remote, Night Job, No Degree
Virtual Assistant, $50/hr, Remote, Part-Time, Evening Job
Remote Customer Support, $42/hr, Weekend, No Experience
Phone Job, $45/hr, Remote, Night Shift, No Degree
Remote Live Chat, $50/hr, College Student, No Experience
Data Entry, $40/hr, Part-Time, Remote, Weekend Job
Virtual Assistant, $42/hr, Remote, No Experience, Evening
Remote Phone Support, $45/hr, Night Job, College Student
Remote Moderator, $50/hr, No Degree, Weekend, Part-Time
Virtual Assistant, $40/hr, Remote, Night Shift, No Experience
Customer Support, $42/hr, Remote, Part-Time, No Degree
Remote Data Entry, $45/hr, Weekend Job, College Student
Phone Support, Remote, $50/hr, No Experience, Night Shift
Virtual Assistant, $42/hr, Evening, Remote, College Student
Live Chat Support, $45/hr, Part-Time, Remote, No Degree
Data Entry, $50/hr, Remote, Evening Job, College Student
Virtual Assistant, $40/hr, Weekend, Remote, No Experience
Remote Phone Job, $42/hr, Night Shift, College Student Friendly
Remote Customer Support, $45/hr, No Degree, Evening Job
Virtual Assistant, $50/hr, Part-Time, Remote, Weekend Job
Data Entry, $40/hr, Evening Job, No Experience, Remote
Remote Live Chat, $42/hr, Weekend, No Degree, Part-Time
Virtual Assistant, $45/hr, No Experience, Remote, Night Job
Phone Job, $50/hr, Remote, Part-Time, College Student
Remote Data Entry, $42/hr, Evening/Night Job, No Experience
Remote Moderator, $45/hr, No Degree, Weekend Job, Part-Time
Live Chat Support, $50/hr, Remote, Night Shift, No Degree
Virtual Assistant, $40/hr, Weekend, College Student, Remote
Remote Phone Job, $42/hr, Part-Time, No Experience Required
Remote Data Entry, $45/hr, No Degree, Weekend, Night Job
Virtual Assistant, $50/hr, Evening, Remote, College Student
Customer Support, $42/hr, Weekend Job, Remote, No Degree
Phone Support, $45/hr, Remote, No Experience, Evening Job
Data Entry, $50/hr, Night Shift, No Degree, Remote Job
- Communicate with doctors, customers, and insurance companies to resolve insurance issues.
- Understand insurance formularies to support cost-saving alternatives and explore options such as applying coupons to meet customer needs.
- Assess and initiate the Prior Authorization (PA) process as needed, ensuring alignment with provider recommendations and customer preferences.
- Clearly explain prescription options to customers and providers, prioritizing the best outcome for the customer.
- Ensure that coding on claims follow payer guidance and lead to maximum reimbursement by third-party payers.
Requirements
- Preferred: You have direct experience working with dermatology-specific medications and insurance processes, including high-cost treatments, specialty medications, and prior authorization workflows commonly associated with dermatological care.
- You have or are willing to obtain a New Jersey Technician Registration before start date
- You have 2+ years of experience as a pharmacy technician working closely with claims adjudications. PTCB certification preferred, but not required.
- You are familiar with industry specific terminology (SIG codes, both brand and generic names of medications)
- You have access to a reliable computer with audio and video capabilities, including high-speed internet of at least 100 Mbps
- You have flexible availability. Schedules will be set in conversation with hiring managers and may include both weekday and weekend hours or morning, afternoon, and evening shifts - specifically Monday to Friday: 8am - 8pm EST and Saturday to Sunday: 10am - 6pm EST.
- You work hard and enjoy the process, combining emotional intuition for a great consumer experience with analytical rigor to improve pharmacy processes, celebrating wins along the way.
What We Offer
- Competitive compensation, commensurate with qualifications and experience
- Comprehensive benefits package including medical, dental, and vision coverage
- The opportunity to work alongside some of the brightest minds in healthcare and technology
- The opportunity to execute on a high-impact mission, to build a pharmacy that works for everyone, within a $425 billion pharmacy industry touching 70% of Americans once a month
Capsule is committed to hiring the best team possible to build a pharmacy that works for everyone. We have a diverse set of problems to solve and believe that we need a diverse set of perspectives to deliver the best possible solutions to those problems. We look for talent from a wide range of backgrounds - including but not limited to - race, age, sexual orientation, gender identity and expression, national origin, religion, disability, and veteran status.
