Oncology prior authorisation

5 days ago


Delhi, India Taglynk Full time

Role OverviewAs a Cover My Meds Specialist, you will be responsible for managing electronic prior authorizations (e PAs) 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 minimize delays in patient care.Key Responsibilities- Manage and process electronic prior authorizations (e PAs) through Cover My Meds, 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 Cover My Meds 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 Risa Labs’ internal teams to support patient access initiatives.Qualifications- Bachelor’s degree in healthcare, pharmacy, life sciences, or a related field (preferred).- 1+ years of hands-on experience using Cover My Meds, 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.



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