Oncology Prior Authorisation

3 days ago

Bengaluru, Karnataka, India Taglynk Full time

Role Overview

As a CoverMyMeds Specialist, you will be responsible for managing electronic prior authorizations (ePAs) and ensuring timely and accurate processing of oncology-related prescriptions. You will work closely with prescribers, pharmacies, and payers to streamline access to critical oncology treatments and minimize delays in patient care.

Key Responsibilities

  • Manage and process electronic prior authorizations (ePAs) through CoverMyMeds, focusing on oncology medications.
  • Review clinical documentation and ensure completeness and accuracy for payer submission.
  • Collaborate with healthcare providers, insurance companies, and specialty pharmacies to resolve prior authorization and reimbursement issues.
  • Monitor and track prior authorization requests, ensuring timely follow-up and resolution.
  • Educate prescribers' offices and staff on CoverMyMeds processes and payer requirements.
  • Stay updated on oncology drug access pathways, insurance policies, and payer-specific rules.
  • Document case activities accurately in CRM or patient management systems.
  • Work cross-functionally with Risa Labs' internal teams to support patient access initiatives.

Qualifications

  • Bachelor's degree in healthcare, pharmacy, life sciences, or a related field (preferred).
  • 2+ years of hands-on experience using CoverMyMeds, specifically in prior authorization processing.
  • Strong background in oncology medication access, reimbursement, or patient services.
  • Familiarity with specialty pharmacy operations and payer requirements.
  • Excellent communication and problem-solving skills.
  • Strong attention to detail, organizational skills, and ability to handle multiple cases simultaneously.

Preferred Skills

  • Experience working with oncology patient support programs.
  • Knowledge of insurance verification, appeals, and reimbursement landscape.
  • Ability to work independently while collaborating with cross-functional teams.

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