Oncology Prior Authorization Specialist

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

Preferred Skills