We are seeking a detail-oriented Pharmacy Prior Authorization Specialist with experience in U.S. pharmacy, prior authorization, or healthcare operations. The ideal candidate will be responsible for handling end-to-end pharmacy prior authorization requests, coordinating with pharmacies, physicians, insurance carriers, and PBMs, resolving claim-related issues, and ensuring timely approvals and renewals for U.S. patients.

Role Requirements

- Shift Timings (US Shift): 6:30 PM to 3:30 AM / 7:30 PM to 4:30 AM

- Working Days: Monday to Friday

- Employment Type: Full time, Permanent, WFO

Key Responsibilities

- Handle end-to-end pharmacy prior authorization requests for U.S. patients.

- Submit and follow up on prior authorizations, renewals, reconsiderations, and appeals.

- Coordinate with U.S. pharmacies, physicians, insurance carriers, and PBMs.

- Review insurance coverage, claim rejections, and required documentation.

- Resolve pharmacy claim rejections and coordinate with relevant stakeholders for resolution.





- Review and maintain accurate authorization and patient records.

- Ensure timely follow-ups on pending authorizations, renewals, and appeals.

- Work with payer portals and platforms such as CoverMyMeds to process authorization requests.

- Handle patient information in compliance with HIPAA and applicable U.S. healthcare requirements.

- Maintain accurate documentation and records of all authorization activities.

Required Skills & Experience

- 2+ years of experience in U.S. pharmacy prior authorization.

- Knowledge of U.S. pharmacy insurance, Medicare, Medicaid, and commercial insurance plans.

- Understanding of pharmacy claims, NDCs, and claim rejection resolution.

- Experience with CoverMyMeds or payer portals is preferred

- Strong English communication and interpersonal skills

- Excellent attention to detail and organizational skills

- Ability to manage multiple authorization requests and meet turnaround times

📌 Pharmacy Prior Authorization Specialist - U.S. Healthcare (Mumbai Suburban)
🏢 Hanr Support Services
📍 Mumbai Suburban