Prior Authorization Specialist - Blue Health Informatics
Taraki
Date: 2 weeks ago
City: Lahore
Contract type: Full time
This job is with Blue Health Informatics. Blue Health builds healthcare technology and select complementary products that make a real difference. We move fast, learn continuously, and care deeply about the people who use our products and the teammates who build them.
Role Overview
Blue Health is seeking a motivated Pharmacist for Prior Authorization Specialist job role (also known as Clinical Authorization Coordinator) to support our prior authorization process. This is a non-clinical role designed for healthcare professionals eager to combine medical expertise with cutting-edge technology in a modern, innovation-driven environment modeled on U.S. healthcare standards.
(PharmD students are encouraged to apply)
Key Responsibilities:
Role Overview
Blue Health is seeking a motivated Pharmacist for Prior Authorization Specialist job role (also known as Clinical Authorization Coordinator) to support our prior authorization process. This is a non-clinical role designed for healthcare professionals eager to combine medical expertise with cutting-edge technology in a modern, innovation-driven environment modeled on U.S. healthcare standards.
(PharmD students are encouraged to apply)
Key Responsibilities:
- Review and process prior authorization requests for medical services, procedures, and prescriptions.
- Apply clinical judgment and payer guidelines to assess medical necessity.
- Ensure compliance with HIPAA and payer-specific standards.
- Collaborate with physicians, pharmacists, and healthcare providers to obtain supporting documentation.
- Maintain detailed and accurate case records in EHR/EMR systems.
- Assist in managing denials and appeals when required.
- Use AI-powered tools to streamline workflows and enhance decision-making efficiency.
- Strong knowledge of medical terminology and insurance payer guidelines.
- Prior experience in utilization management, authorization, or clinical review is highly preferred.
- Excellent communication, organization, and analytical skills with great attention to detail.
- Bachelors degree in Nursing, Pharmacy, Allied Health, or an equivalent clinical discipline.
- Preferred: MBBS, DPT, or PharmD.
- Ability to work independently in a fast-paced, tech-enabled environment.
- Familiarity with EHR/EMR systems and healthcare insurance workflows.
- Access to cutting-edge AI tools that boost learning, efficiency, and communication.
- Working here naturally improves your accent and communication skills, helping you excel in international healthcare language exams.
- Professional connections & internship opportunities within the U.S. healthcare system.
- A culture that rewards innovation, encourages creativity, and recognizes individual contributions.
- No-boss culture: flat, collaborative structure focused on mentorship and personal growth.
- Experience a U.S.-style healthcare work environment blending operations, learning, and innovation.
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