Prior Authorisation Specialist

24 hours ago

Bharatpur, Rajasthan, India beBeeOncology Full time ₹ 12,00,000 - ₹ 15,00,000
Oncology Prior Authorisation Specialist

Job Summary:

We are seeking an experienced Oncology Prior Authorisation Specialist to manage electronic prior authorisations and ensure timely processing of oncology-related prescriptions.

Key Responsibilities:

  • Prior Authorisation Processing: Manage and process electronic prior authorisations through CoverMyMeds, focusing on oncology medications.
  • Clinical Review: Review clinical documentation and ensure completeness and accuracy for payer submission.
  • Collaboration and Communication: Collaborate with healthcare providers, insurance companies, and specialty pharmacies to resolve prior authorisation and reimbursement issues.
  • Case Management: Monitor and track prior authorisation requests, ensuring timely follow-up and resolution.
  • Education and Training: Educate prescribers' offices and staff on CoverMyMeds processes and payer requirements.
  • Stay Up-to-Date: Stay updated on oncology drug access pathways, insurance policies, and payer-specific rules.
  • Documentation: Document case activities accurately in CRM or patient management systems.

Requirements:

  • Bachelor's degree in healthcare, pharmacy, life sciences, or a related field (preferred).
  • 2+ years of hands-on experience using CoverMyMeds, specifically in prior authorisation 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.

Preferred Skills:

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

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