Electronic Prior Authorization Specialist

22 hours ago

Salem, Tamil Nadu, India beBeeOncology Full time ₹ 9,00,000 - ₹ 12,00,000
Job Summary

We are seeking a skilled and dedicated professional to manage electronic prior authorizations for oncology-related prescriptions.

Key Responsibilities:
  • Process and manage electronic prior authorizations 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.
  • Work cross-functionally with internal teams to support patient access initiatives.
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 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, organizational 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.
What You'll Bring:
  • A strong passion for delivering high-quality patient care and exceptional customer service.
  • Excellent analytical and problem-solving skills, with the ability to navigate complex issues.
  • Exceptional communication and interpersonal skills, with the ability to build strong relationships with healthcare professionals.
  • Proven ability to work effectively in a fast-paced environment, managing multiple priorities and deadlines.

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