
Prior Authorization Specialist
4 days ago
We are seeking a skilled specialist to manage electronic prior authorisations and ensure timely and accurate processing of oncology-related prescriptions through CoverMyMeds.
Key Responsibilities:
- Manage and process electronic prior authorisations 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.
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, organisational skills, and ability to handle multiple cases simultaneously
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