Afrah Ali
@afrahali
I manage accurate US healthcare prior authorizations, appeals, and clinical documentation workflows.
IndiaWhat I'm looking for
I'm currently handling end-to-end prior authorization workflows for US healthcare providers at Staffingly Inc., supporting Commercial and Medicaid plans through payer portals, provider communication, and EHR/EMR documentation.
I review clinical documentation, formulary requirements, step-therapy criteria, and denial reasons; prepare appeals; and maintain HIPAA-compliant, accurate authorization records using Availity, CoverMyMeds, Predictal, and Medent.
My PharmD background includes clinical pharmacy work at Mythri Hospital, clinical research documentation at Fernandez Hospital, and quality and customer operations experience at Amazon Development Centre.
Experience
Work history, roles, and key accomplishments
Prior Authorization Specialist
Staffingly Inc.
Feb 2026 - Present (8 months)
Handles end-to-end prior authorization processes for US healthcare providers and insurance plans, working with Commercial and Medicaid payers. Reviews clinical documentation, prepares appeals, and maintains HIPAA compliance.
Clinical Pharmacist
Mythri Hospital
Jul 2023 - Jul 2024 (1 year)
Contributed to improved clinical documentation quality and interdisciplinary coordination. Supported antimicrobial stewardship initiatives and guideline-based therapy recommendations.
Intern - General Medicine
Gandhi Hospital
Sep 2022 - Aug 2023 (11 months)
Supported clinical documentation, patient monitoring, and case record maintenance.
Audited customer interactions to identify process gaps and compliance issues. Analyzed recurring issues and shared actionable insights with operations teams.
Clinical Research Intern
Fernandez Hospital
Aug 2021 - Jul 2022 (11 months)
Assisted in clinical research documentation, data collection, and structured reporting.
Delivered customer support via email, chat, and calls while meeting quality benchmarks. Resolved order, billing, delivery, and return-related queries through accurate documentation.
Education
Degrees, certifications, and relevant coursework
Chilkur Balaji College of Pharmacy
Doctor of Pharmacy, Pharmacy
2017 - 2023
Completed the Doctor of Pharmacy (PharmD) program from 2017 to 2023.
Tech stack
Software and tools used professionally
Availability
Location
IndiaAuthorized to work in
Salary expectations
Job categories
Skills
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