PAHub & Prior Authorization Specialist
RXinsider
Reports To: Vice President, Customer Experience Location: Remote/Hybrid with 10% travel nationwide Position Summary The PAHub & Prior Authorization Specialist serves as a trusted consultant to customers and internal teams, helping maximize the value, effectiveness, and adoption of PAHub. This role bridges the gap between product functionality, customer operations, implementation, account management, training, and support. The ideal candidate possesses deep knowledge of prior authorization workflows and PAHub capabilities and can effectively communicate with both operational users and executive stakeholders. The Specialist will participate in customer meetings, support internal teams, provide product demonstrations, identify optimization opportunities, and assist in the development of customer-facing documentation and training materials. This role plays a critical part in ensuring customers achieve their desired business outcomes while helping internal teams deliver consistent, high-quality customer experience. Key Responsibilities Customer Engagement & Advisory Serve as a PAHub subject matter expert for customers throughout implementation, optimization, training, and ongoing support activities. Participate in customer calls, workshops, business reviews, and operational meetings. Develop trusted relationships with customer stakeholders by understanding their workflows, goals, challenges, and business requirements. Advise customers on industry best practices and optimal use of PAHub functionality. Identify opportunities to improve customer efficiency, automation, turnaround times, and overall satisfaction. Proactively monitor customer adoption and recommend process improvements and workflow enhancements. Product Demonstrations & Training Conduct PAHub demonstrations for prospective and existing customers. Showcase new features, product enhancements, and best practices. Deliver customer training sessions tailored to different user roles and operational functions. Assist customers in understanding how PAHub functionality supports their business and regulatory requirements. Support onboarding activities for new customers and new customer team members. Internal Team Support Act as a resource for Account Management, Customer Success, Support, Implementation, Product, Training, and Operations teams. Participate in internal customer strategy discussions and planning meetings. Provide guidance on customer workflows, business requirements, and PAHub capabilities. Help internal teams evaluate customer enhancement requests and identify potential solutions. Share customer feedback, trends, and opportunities with Product Management and leadership teams. Product Adoption & Optimization Assess customer utilization of PAHub and identify opportunities for improvement. Recommend workflow changes, configuration updates, and training opportunities to increase efficiency. Help customers leverage existing functionality before pursuing custom development. Support feature adoption initiatives and change management efforts. Track customer challenges and coordinate with internal teams to ensure timely resolution. Documentation & Knowledge Management Partner with the Documentation and Training teams to create, review, and improve customer-facing materials. Validate user guides, training materials, release communications, knowledge articles, and implementation documentation for accuracy and usability. Assist in developing best practice guides, workflow examples, and process documentation. Review customer communications to ensure clear and consistent messaging. Voice of the Customer Gather customer feedback and communicate key themes to Product, Engineering, and Leadership teams. Advocate for customer needs while balancing product strategy and operational considerations. Assist in prioritizing customer requests by providing business and workflow context. Identify recurring customer questions and contribute to continuous improvements in training and documentation. Required Qualifications 5+ years of experience in healthcare operations, prior authorization, utilization management, PBM, health plan operations, specialty pharmacy, or healthcare technology. Hands-on experience with PAHub or a similar prior authorization platform. Strong understanding of prior authorization workflows, operations, and regulatory requirements. Experience working directly with customers in a consultative or client-facing capacity. Excellent presentation, facilitation, and communication skills. Ability to explain complex technical concepts to both technical and non-technical audiences. Strong analytical and problem-solving abilities. Ability to manage multiple priorities in a fast-paced, demanding environment with minimal supervision. Maintain the strictest confidentiality in compliance with HIPAA guidelines. Highly self-motivated, professional, take-charge attitude with humility and integrity. Preferred Qualifications Experience supporting SaaS healthcare applications. Experience in training, customer success, account management, implementation, and/or consulting. Knowledge of CMS, Medicaid, Medicare, and commercial utilization management processes. Pharmacy Technician certification, pharmacist, or related healthcare credentials. Experience creating documentation, training content, or knowledge management materials. Success Measures The PAHub & PA Specialist Will Be Successful When Customers are effectively utilizing PAHub functionality and adopting new features. Customer satisfaction and engagement levels improve. Internal teams have access to timely, accurate product expertise. Product demonstrations and training sessions are highly effective and well-received. Documentation and customer-facing materials are accurate, useful, and easy to understand. Customer feedback is translated into actionable improvements that enhance the overall customer experience. This position offers a unique opportunity to influence customer success, product adoption, and the overall customer experience strategy while serving as a recognized PAHub expert across the organization. Pay Range: Actual compensation will be determined based on the candidate's experience, qualifications, and work location. Candidates in different geographic markets may be offered compensation that reflects local market conditions. Agadia Health Systems, Inc. is a leading healthcare management technology company addressing the evolving needs of the managed care market with a suite of utilization management solutions in electronic prior authorization, MTM, Part D star ratings & adherence, grievances, and formulary benefit design. Used by the nation’s largest health plans and PBMs, Agadia’s advanced technology solutions help drive operational efficiency, appropriate utilization, compliance, and profitability Agadia is an Equal Opportunity Employer #J-18808-Ljbffr
- ...About the Role We're hiring an experienced Prior Authorization Specialist to help build the future of authorization automation for home health and hospice. Prior authorization is one of the largest operational bottlenecks for agencies. Our platform automatically...Suggested
- ...A-Line Staffing Solutions is hiring a Pharmacy Tech I - Prior Authorization for a fully remote position in the United States. The role involves handling inbound calls related to prior authorizations and requires candidates to maintain accurate documentation while providing...SuggestedRemote work
$101.18k - $120.46k
...Business Title(s): Senior Shared Services Specialist Employment Type: Full-Time FLSA... ...and within broad limits and authority,partner with adjuster, auto/property owner... ...for this or any other position without prior authorization from Human Resources will...SuggestedFull timeWork experience placementLocal area- ...Overview Large Cardiology Practice located in Kew Gardens, Queens, is seeking a Prior Authorization Specialist that meets the following requirements: Benefits Competitive salary Health insurance Opportunity for advancement Paid time off Profit sharing Health benefits...Suggested
- ...orthopedic clinics to help optimize operations and improve financial performance. Prior authorizations are a critical component of that success. We are seeking a Prior Authorization Specialist (Contract) to support high-volume authorizations for both procedures and...SuggestedContract work
- ...Representative responsible for managing Care Coordination services and Health Information Management tasks. The role includes prior authorizations, electronic filing, and ensuring compliance with protocols. Ideal candidates will have a High School Diploma, experience in...Remote jobWork from home
$18.92 - $23.46 per hour
...Employee Referral Program. Job Summary Perform duties to initiate authorizations, focusing on accuracy, timeliness, and adherence to processes... ...all revenue opportunities are included to complete and submit prior authorizations timely for payer reimbursement. Communicate...Full timeContract workTemporary workLocal areaRemote workFlexible hours- Prism Vision Group is seeking a Revenue Cycle Specialist located at Spokane Eye Clinic, Spokane, WA. This role involves handling billing and collecting from assigned payors, ensuring compliance with regulations and customer service excellence. Candidates should possess...
$18.67 - $21.96 per hour
...Island, South Carolina, South Dakota, Vermont, West Virginia, and Wyoming. Overview Lumicera Health Services is seeking a Prior Authorization Specialist I to join our team! Under direction from the Supervisor, Specialty Pharmacy Services, and pharmacists in the Specialty...TraineeshipRemote workFlexible hoursShift work- JOB SUMMARY The basic function of the Authorization Specialist is to verify benefits/eligibility and obtain authorizations when necessary for visits... ...authorization is secured with the insurance company prior to scheduled service. Obtains authorization timely when the...Temporary workWork at officeMonday to Friday
$21.38 - $44.4 per hour
...$21.38-$44.40/hr (Dependent on Experience) The Revenue Cycle Specialist is responsible for billing and collecting from their assigned payor... ...School Diploma or General Education Degree (GED) with 3 years prior hands‑on experience in a fast‑paced medical billing environment...- WellDyne is seeking a Prior Authorization Tech II to initiate clinical PA requests by phone or email, create and fax cases, and document all activity with accuracy. You will also complete PA requests via telephone with prescriber staff and work closely with pharmacies,...
- ...Services, PLLC are on the hunt for a meticulous and proactive Authorizations Specialist to keep our clinical services moving without interruption.... ...you secure matters Responsibilities Submit and track prior authorization requests to insurance companies daily Communicate...Hourly pay
- A healthcare services provider is seeking a Prior Authorization Specialist I to ensure the efficient triaging of prior authorizations. This role involves answering calls, contacting providers for necessary information, and documenting patient details. Ideal candidates...Remote workShift work
- ...Solutions and currently, I am looking for a EDI Integration Specialist (Not Developer) for our client . Please see the job... ...healthcare processes including claims, eligibility, payments, and prior authorizations. ~ Solid understanding of XML, JSON, SQL, REST, and...Contract workRemote work
- A U.S.-based healthcare service is seeking a Pre-Authorization & Referral Coordinator to manage insurance verifications, prior authorizations, and referrals for a fast-paced medical office. The ideal candidate should have over 2 years of experience in a U.S. medical setting...Remote jobFull timeFor contractorsWork at office
$20 - $28.8 per hour
...the direction of the Supervisor, Referrals, the Referrals Specialist serves as a primary interface between patients, providers,... ...Epic and insurance portals. Verify eligibility and obtain prior authorizations/pre-certifications as needed. Route/fax medical documentation...Remote jobFull timeWork at office$31.21 per hour
...the “Montefiore Difference” - who we are at Montefiore and all that we have to offer our associates, please click here. OUTREACH SPECIALIST (Full-Time) Days/Hours required:: Mon/Wed/Fri - 9am-5:30pm Tues/Thurs - 12pm-8:30pm University Behavioral Associates (UBA) at...Hourly payFull timeWork at officeTrial periodShift workAfternoon shift$37.44k - $50.16k
Job Posting Title: Asset Protection Specialist Part-Time Req ID: 10156054 Job Description: At Disney, we are storytellers. We make the impossible, possible. The Walt Disney Company is a world-class entertainment and technological leader. Walt’s passion was to continuously...Part timeShift workWeekend work- ...Trusted | Work Together | Strive for Excellence. Join Our Prior Authorization Team at Logan Health! Location: Remote (see approved states... ...healthcare? We're looking for a detail-oriented Prior Authorization Specialist to ensure a smooth and efficient process for obtaining...Full timeWork at officeRemote workShift workDay shift
$20.31 per hour
Prior Authorization Specialist Love + medicine is who we are, it's what we do, it's why people want to work here. If you're looking for a job to love, apply today. We're not just filling positions, we're building careers. At Emplify Health, we care for our teams, while...Full timeRemote workMonday to FridayShift work- Silna Health Prior Authorization And Benefits Verifications Expert Silna Health attacks the root cause of denied claims: the fragmented, incompatible systems that govern prior authorizations, eligibility verification, and benefit checks, turning workflows that used to take...Hourly payFull timeFor contractorsRemote work
$18 per hour
...technology platform to track adherence with a world-class pharmaceutical packing and distribution facility. About the Role The Prior Authorization Specialist is responsible for obtaining prior authorizations for all prescriptions that require insurance carrier authorizations....Hourly payMinimum wageTemporary workH1bWork at officeLocal areaHome officeVisa sponsorshipWork visa- Prior Authorization Specialist We are seeking a detail-oriented and experienced Prior Authorization Specialist to manage the full lifecycle of prior authorizations (PAs) for medical services. The ideal candidate will be responsible for timely submission, meticulous follow...FreelanceRemote workWorldwide
- ...Job Description Job Description LaSante Health Center is seeking a Referrals and Prior Authorization Specialist to join our team. The ideal candidate will help ensure patients have seamless access to medications, diagnostic imaging, and specialty care by managing...
$34.78 - $37.8 per hour
Title: Pre-Authorization Specialist Location: Upper East Side Org Unit: Clinical Operations Work Days: Monday-Friday Weekly Hours:... ...of insurance verifications, eligibility and benefits, and prior authorizations for services provided. Serves as liaison between...Full timeWork at officeLocal areaMonday to Friday$23 - $25 per hour
...responsible for general clinical administrative tasks such as retrieving medical records, processing referrals and obtaining prior authorizations Prepare for and participate in daily huddles to support smooth clinic operations About You Passionate about improving...Full timeContract workFor contractorsFor subcontractorWork at officeFlexible hours$65k - $75k
...innovative, collaborative, and inclusive. As a Candidate Experience Specialist, you’ll be the face of NBCU for prospective talent, ensuring... ...with an NBCUniversal employee at one of our locations prior to a hiring decision. NBCUniversal's policy is to provide equal...Full timeWork at officeLocal area$32.39 - $36.04 per hour
...at the time of this job advertisement and may be modified in the future. What you will be doing Description The Patient Access Specialist serves as the primary point of contact for patients and visitors at the Ambulatory Surgery Center, ensuring a positive and...Full timeLocal areaShift work$68.9k - $99.62k
Community Relations Specialists are on the front lines of improving the lives of New Yorkers by connecting people to health-insurance... ...please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money...Full timeTemporary workWork experience placementLocal areaNight shiftWeekend work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to PAHub & Prior Authorization Specialist. Be the first to apply!
- recovery specialist New York, NY
- instructional specialist New York, NY
- evaluation specialist New York, NY
- professional specialist New York, NY
- learning management system specialist New York, NY
- government relations specialist New York, NY
- patient experience specialist New York, NY
- zoning specialist New York, NY
- appeals specialist New York, NY
- ergonomic specialist New York, NY

