Prior Authorisation Specialist

12 hours ago

Allahabad, Uttar Pradesh, India beBeeOncology Full time ₹ 5,00,000 - ₹ 10,00,000
Job Overview

As a specialist in prior authorisation management, you will be responsible for facilitating timely and accurate processing of oncology-related prescriptions. Your role will entail managing electronic prior authorisations through CoverMyMeds, focusing on oncology medications.

Key Responsibilities:

  • Manage and process electronic prior authorisations through CoverMyMeds, concentrating on oncology medications.
  • Review clinical documentation to ensure completeness and accuracy for payer submission.
  • Collaborate with healthcare providers, insurance companies, and specialty pharmacies to resolve prior authorisation and reimbursement issues.
  • Monitor and track prior authorisation 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 internal teams to support patient access initiatives.

Qualifications

  • Bachelor's degree in healthcare, pharmacy, life sciences, or a related field (preferred).
  • At least 2 years of hands-on experience using CoverMyMeds, specifically in prior authorisation processing.
  • A 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, organisational skills, and ability to handle multiple cases simultaneously.

Preferred Skills

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

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