Pharmacist – Prior Authorization Specialist

About the role

Orange Tree Systems is looking for licensed pharmacists or PharmD students to join its Prior Authorization Specialist team. This non‑clinical, operations‑focused position lets you apply clinical knowledge to U.S. insurance workflows while working with AI‑enabled healthcare tools.

Key responsibilities

• Review and process prior authorization requests for services, procedures, and prescription medications.
• Apply evidence‑based criteria and clinical judgment to assess medical necessity.
• Maintain compliance with HIPAA and ensure accurate case documentation in EHR/EMR systems.
• Collaborate with physicians, nurses, and other providers to gather supporting clinical information.
• Assist with denial appeals and leverage AI‑powered tools to improve efficiency and decision‑making.

Required profile

• Licensed pharmacist, PharmD graduate or current PharmD student.
• Strong understanding of medical terminology and clinical documentation.
• Prior exposure to prior authorization, utilization management, or medical insurance workflows is preferred.
• Excellent communication, organizational and analytical abilities with high attention to detail.

Required skills

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

What we offer

• Access to cutting‑edge AI healthcare platforms.
• Opportunities to improve professional English and medical communication.
• Mentorship‑driven, flat‑structure environment with global exposure.
• Potential pathways to internships and professional connections within the U.S. healthcare system.