Prior Authorisation Specialist

6 days ago

Ahmedabad, Gujarat, India beBeeOncology Full time ₹ 45,00,000 - ₹ 55,00,000
Job Title: Oncology Prior Authorisation Specialist

We are seeking a highly skilled and experienced Oncology Prior Authorisation Specialist to join our team. In this role, you will be responsible for managing electronic prior authorisations (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 minimise delays in patient care.

  • Manage and process electronic prior authorisations (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 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.
Requirements:
  • Bachelor's degree in healthcare, pharmacy, life sciences, or a related field.
  • 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 programs.
  • Knowledge of insurance verification, appeals, and reimbursement landscape.
  • Ability to work independently while collaborating with cross-functional teams.

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