Doctor / Medical Background

Blue Health is seeking a Prior Authorization Specialist a non Clinical role (also known as Clinical Authorization Coordinator) with a medical or allied health science background for a non-clinical role supporting our prior authorization process. (Students are encouraged to apply) This position combines healthcare expertise with cutting-edge technology and offers a dynamic, innovation-driven environment modeled on US healthcare standards.Key responsibilities:Review prior authorization requests for medical services, procedures, and prescriptions.Apply clinical knowledge and payer guidelines to assess medical necessity.Ensure compliance with HIPAA and payer-specific requirements.Coordinate with physicians, pharmacists, and healthcare providers to obtain supporting documentation.Maintain accurate case records in EHR/EMR systems.Support appeals and denials management when required.Leverage AI-based tools to streamline authorization workflows and improve decision-making efficiency.Requirements:Background in Nursing, Pharmacy, or Allied Health Sciences (RN, LPN, BSN, PharmD, CPhT, or equivalent).Strong understanding of medical terminology and payer guidelines.Prior experience in utilization management, authorization, or clinical review is highly preferred.Excellent communication, organizational, and analytical skills with attention to detail.Qualifications:Bachelor’s degree in Nursing, Pharmacy, Allied Health, or equivalent clinical field.Preferred: MBBS, DPT, or PharmD.Ability to work independently in a fast-paced, tech-enabled environment.Familiarity with EHR/EMR systems and insurance workflows.Why Blue health:Exposure to cutting-edge AI tools that enhance efficiency, learning, and communication.At Blue Health, your accent naturally improves through regular communication practice, supporting success in international healthcare language exams.Professional connections and internship opportunities in the US healthcare system.A culture that rewards innovation, encourages creative development, and recognizes individual contribution.No-boss culture work in a flat, collaborative structure focused on mentorship and growth.Experience a US-style work environment blending healthcare operations and continuous learning.