Prior Authorizations-Oncology

3 days ago


Bengaluru, Karnataka, India Taglynk Full time ₹ 5,00,000 - ₹ 12,00,000 per year

As a CoverMyMeds Specialist, you will be responsible for managing electronic prior authorizations (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 minimize delays in patient care.

Key Responsibilities


• Manage and process electronic prior authorizations (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 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.

Qualifications


• 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 tea



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