Pharmacist / Prior Authorization Specialist

About the role

Orange Tree Systems is seeking a Pharmacist to work as a Prior Authorization Specialist. In this role you will apply clinical expertise to evaluate insurance requests for medical services and medications, using AI‑enabled tools to support U.S. healthcare operations. The position is based in Lahore and operates on a night shift schedule.

Key responsibilities

• Review and process prior‑authorization requests for services, procedures, and prescription drugs.
• Apply evidence‑based criteria and clinical judgment to determine medical necessity.
• Maintain HIPAA compliance in all interactions and documentation.
• Collaborate with physicians, pharmacists, nurses and other providers to obtain supporting clinical information.
• Record detailed case information in EHR/EMR systems.
• Assist with appeals for denied authorizations when required.
• Leverage AI‑powered tools to streamline workflow and improve decision‑making efficiency.

Required profile

• PharmD degree (or current PharmD student) with 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 abilities with high attention to detail.
• Ability to manage multiple cases efficiently in a fast‑paced environment.

Required skills

• Familiarity with EHR/EMR systems.
• Experience using AI‑enabled workflow tools.
• Knowledge of HIPAA regulations.

What we offer

• Access to cutting‑edge AI healthcare tools that enhance productivity and learning.
• Opportunities to improve professional English and medical communication for international exams.
• Professional connections and internship pathways within the U.S. healthcare system.
• Innovation‑driven, flat‑hierarchy culture focused on mentorship and growth.
• Accommodation for candidates relocating to Lahore.
• Market‑competitive salary with performance‑based increments and bonuses.