Orange Tree Systems (OTS) is hiring Pharmacists for the Prior Authorization Specialist role

to support U.S. healthcare prior authorization and utilization management processes. This is a non-clinical, operations-focused role ideal for healthcare professionals who want to apply their clinical knowledge in a technology-driven, U.S.-style healthcare environment.

This position is well-suited for licensed pharmacists, PharmD graduates, and PharmD students who are eager to gain exposure to insurance workflows and AI-enabled healthcare operations.

PharmD students are encouraged to apply.

🩺 Key Responsibilities

• Review and process prior authorization requests for medical services, procedures, and prescription medications
• Apply clinical judgment, evidence-based criteria to determine medical necessity
• Ensure compliance with HIPAA
• Collaborate with physicians, pharmacists, nurses, and healthcare providers to obtain supporting clinical documentation
• Maintain accurate and detailed case records within EHR/EMR systems
• Assist with authorization denials appeals as required
• Utilize AI-powered tools to streamline workflows and improve efficiency and decision-making

📋 Requirements

• Strong understanding of medical terminology and clinical documentation
• Prior experience in prior authorization, utilization management, clinical review, or medical insurance workflows is highly preferred
• Excellent communication, organizational, and analytical skills
• High attention to detail and ability to manage multiple cases efficiently

🎓 Preferred Qualifications

• Bachelor’s degree in Pharmacy, MBBS, Allied Health, or an equivalent clinical discipline
• Preferred qualifications: PharmD, MBBS, DPT, MLT
• Ability to work independently in a fast-paced, technology-enabled environment
• Familiarity with EHR/EMR systems and U.S. healthcare insurance workflows

🌟 Why Join 

Orange Tree Systems (OTS)?

• Access to cutting-edge AI healthcare tools that enhance learning, productivity, and communication
• Improve professional English, medical communication, and accent, supporting international healthcare exams
• Build professional connections and internship pathways within the U.S. healthcare system
• Innovation-driven culture that values creativity, ownership, and impact
• No-boss culture with a flat, collaborative structure focused on mentorship and growth
• Hands-on experience in a U.S.-style healthcare operations environment blending learning and innovation

🚀 Apply Now

Join Orange Tree Systems and become part of a team shaping the future of healthcare operations through technology, collaboration, and global exposure.