Pharmacist
2 weeks ago
Pharmacist (Insurance Drug Coverage Policy Analyst – US Market)
Location: Pakistan (Onsite – supporting US operations)
Position Type: Full-Time
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About the Role
We are looking for a Pharmacist with strong expertise in US healthcare coverage, prior authorization, and billing processes to join our team. This role involves reviewing and analyzing insurance drug coverage policies to extract criteria, coding requirements, and rules for medicines under both medical and pharmacy benefits.
The selected candidate will work onsite in Pakistan, supporting a US-based healthcare services company.
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Key Responsibilities
Insurance Policy Review
• Review and interpret payer drug coverage policies (medical & pharmacy).
• Extract and organize coverage criteria, coding requirements, and rules.
Coverage Data Management
• Build and maintain structured databases of drug coverage information.
• Translate complex policy language into clear, actionable reference materials.
Prior Authorization & Billing Expertise
• Apply knowledge of prior authorization workflows and billing processes.
• Ensure alignment with payer requirements across ICD-10, CPT, and HCPCS codes.
Analytics & Reporting
• Monitor payer policy updates and coverage changes.
• Develop reports, trackers, and dashboards to highlight trends and variations.
Technology & Tools
• Use Microsoft Excel and other digital tools for data management and reporting.
• Maintain accurate and updated records in internal portals.
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Qualifications & Requirements
Education
• Bachelor of Pharmacy (BPharm) or Doctor of Pharmacy (PharmD).
Experience
• 2–4 years of experience in US healthcare prior authorization, billing, or insurance policy review.
• Strong understanding of ICD-10, CPT, and HCPCS coding.
• Prior exposure to insurance drug coverage policies preferred.
Skills
• Strong research and analytical abilities.
• Proficiency in Microsoft Excel and reporting tools.
• Excellent written English communication.
• Ability to work independently, meet deadlines, and collaborate with US-based teams.
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Why Join Us?
• Be part of a global healthcare services team.
• Work on impactful projects that directly support healthcare delivery.
• Gain exposure to the US healthcare system while working from Pakistan.
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How to Apply
Interested candidates can apply by sending their CV to
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