Medical Oncology Prior Authorisation Specialist

5 days ago

Bhavnagar, Gujarat, India beBeeOncology Full time ₹ 63,29,154 - ₹ 90,16,843
Job Description

As a specialist in oncology prior authorisations, you will play a pivotal role in ensuring timely and accurate processing of cancer-related prescriptions. You will collaborate closely with prescribers, pharmacies, and payers to streamline access to critical oncology treatments and minimise delays in patient care.

  • Process electronic prior authorisations through CoverMyMeds, focusing on oncology medications.
  • Review clinical documentation for completeness and accuracy before 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.
  • Provide educational support to prescribers' offices and staff on CoverMyMeds processes and payer requirements.
  • Stay updated on oncology drug access pathways, insurance policies, and payer-specific rules.

Responsibilities:

The ideal candidate will have strong analytical skills, attention to detail, and the ability to multitask effectively. They must also be able to work independently and collaboratively within cross-functional teams.

Required Skills and Qualifications

Essential Qualifications:

  • Bachelor's degree in healthcare, pharmacy, life sciences, or a related field (desired).
  • At least 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.

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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