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Posted: 10/21/2026Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing prior authorization processes and eligibility verification within healthcare operations, ensuring compliance with HIPAA standards while maintaining accurate member records. Proficient in coordinating with various stakeholders, including providers and pharmacy partners, to facilitate seamless patient care.
Highest-signal resume keywords
Prior Authorization ManagementEligibility VerificationHealthcare Administrative ExperienceCRM or EHR ProficiencySpanish Fluency
About the role
Key responsibilities & impact- Run benefit eligibility checks to confirm coverage, cost-share, and authorization requirements before care begins
- Keep eligibility status accurate and current for every active member
- Manage medical prior authorization requests, renewals, and extensions across payers and specialty pharmacy partners end to end
- Prepare and submit prior authorization documentation
- Track approval status and escalate stalled or denied authorizations before they delay care
- Follow up proactively with provider offices for unsigned documents and orders
- Process incoming referrals, faxes, and clinical documents and route them appropriately
- Coordinate clinical staffing with staffing agencies
- Coordinate medication shipping with pharmacy partners
- Answer and triage inbound calls from providers, pharmacy partners, and occasionally members
- Document call details accurately and follow through on action items
- Represent Leap professionally with a service-oriented approach
- Collect, organize, and store member records and clinical documentation
- Ensure files meet internal standards and HIPAA compliance requirements
- Design, document, and continuously improve operational workflows
- Report to the Head of Member Ops. & Strategy
Requirements
What you’ll need- 2+ years in a healthcare administrative or operations role supporting prior authorization or eligibility verification
- Familiarity with payer portals, PA workflows, and follow-up/appeal processes
- Proficiency with CRM or EHR systems and document management platforms, including fax
- Proven track record managing high volumes of detailed work accurately
- Comfort coordinating across provider offices, payers, pharmacy partners, staffing agencies, and internal teams
- Strong organizational and communication skills
- Ability to work independently during CST business hours in a fully remote setting
- Clinical certification or licensure (CMA, RMA, CPhT, LPN, or similar) is a bonus
- Experience in a healthcare startup or high-growth environment is a bonus
- Experience in specialty infusion, home infusion, or rare disease programs is a bonus
- Spanish fluency, spoken and written, is a bonus
- Legal authorization to work in the United States is requested in the application
Benefits
Comp & perks- Competitive salary
- Stock options/equity
- Competitive health, dental, and vision coverage
- 401(k) retirement plan
- Fully remote work
- Opportunity to build operational infrastructure from the ground up at a fast-growing company
- Limit of up to 3 applications in any 90-day period across jobs in this group
- Reapplication to the same role after 60 days if not offered a role
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Benefit Eligibility ChecksPrior Authorization DocumentationOperational Workflow DesignClinical Documentation ManagementHigh Volume Work Management
Soft Skills
Strong Organizational SkillsEffective Communication SkillsService-Oriented Approach
Tools & Technologies
Payer PortalsDocument Management PlatformsFax Systems
Certifications & Qualifications
CMARMACPhTLPN
Industry Keywords
Healthcare OperationsSpecialty InfusionHome InfusionRare Disease ProgramsHIPAA Compliance