Prior Authorization Pharmacist
5 days ago
Job description
Job Title:
Pharmacist – Prior Authorization Specialist
Company:
Devstax
Location:
On-site
Shift Timing:
6:00 PM – 3:00 AM
(Pakistan Standard Time)
Employment Type:
Full-time
Experience: Must Have
3 Years Experience
Job Summary:
The Pharmacist – Prior Authorization Specialist will be responsible for managing and processing prior authorization requests for prescription medications. The ideal candidate will have prior experience working with U.S. healthcare systems, insurance plans, and pharmacy benefit managers (PBMs). This role requires strong communication skills, attention to detail, and a commitment to delivering accurate, timely service during the night shift.
Key Responsibilities:
- Review and process prior authorization (PA) requests for medications in compliance with insurance and regulatory requirements.
- Communicate with healthcare providers, insurance companies, and patients to obtain necessary documentation and information.
- Evaluate clinical information and patient records to ensure requests meet medical necessity and coverage criteria.
- Accurately document all interactions, decisions, and follow-ups in the system.
- Collaborate with internal teams to resolve PA-related issues efficiently.
- Maintain knowledge of formulary changes, drug coverage policies, and insurance guidelines.
- Ensure compliance with HIPAA and other relevant healthcare regulations.
Qualifications & Requirements:
- Bachelor's or Doctor of Pharmacy (Pharm-D) degree from an accredited institution.
- Valid pharmacy license (Pakistan license acceptable; U.S. licensure a plus).
- 3+ years of experience in prior authorization
, utilization management, or related U.S. healthcare roles. - Strong understanding of U.S. insurance processes, PBMs, and pharmacy workflows.
- Excellent English communication skills (both written and verbal).
- Proficient in EHR/EMR systems, and general computer literacy (MS Office, Google Workspace).
- Ability to work independently during night shifts (6 PM – 3 AM PST).
Preferred Skills:
- Experience working in a U.S. healthcare BPO, PBM, or telepharmacy environment.
- Familiarity with Medicare/Medicaid and commercial insurance plans.
- Detail-oriented with excellent problem-solving and decision-making skills.
What We Offer:
- Competitive salary and performance-based incentives.
- Opportunity to work with a professional U.S.-based healthcare team.
- Supportive work environment with growth and learning opportunities.
- Health and wellness benefits (as applicable).
How to Apply:
Interested candidates may send their CV/Resume to
with the subject line:
"Pharmacist – Prior Authorization"
- WhatsApp
.
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