CoverMyMeds Oncology Prior Authorisation Specialist

2 weeks ago

Guntur, Andhra Pradesh, India beBeeOncology Full time ₹ 9,60,000 - ₹ 13,60,000
CoverMyMeds Oncology Prior Authorisation Specialist

The CoverMyMeds Oncology Prior Authorisation Specialist will play a pivotal role in streamlining electronic prior authorisations and ensuring timely processing of oncology-related prescriptions. This position involves collaborating closely with healthcare providers, insurance companies, and specialty pharmacies to facilitate access to critical oncology treatments and optimise patient care.

Job Responsibilities:

  • Manage and process electronic prior authorisations (ePAs) through CoverMyMeds, focusing on oncology medications.
  • Review clinical documentation for completeness and accuracy prior to 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.

Key Qualifications:

  • Bachelor's degree in a relevant field such as healthcare, pharmacy, life sciences, or a related discipline.
  • 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.

Prior Experience:

  • Working with oncology patient support programs.
  • Knowledge of the insurance verification, appeals, and reimbursement landscape.

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