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
Robust 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 (India)
🏢 Hanr Support Services
📍 India