Job Description (JD)
Industry: US Healthcare / Pharmacy
Key Responsibilities:
Contact doctors' offices to obtain prior authorisation (PA) approvals for prescribed medications.
Submit prior authorisation requests through Cover My Meds and other payer portals.
Follow up with providers and insurance companies on pending PA requests.
Review and work on denied prior authorisation cases by collecting required clinical information and resubmitting appeals as needed.
Update and tag the status of each case accurately (e.g., PA Approved, PA Denied, Pending).
Maintain complete and accurate documentation in the system.
Coordinate with internal teams to ensure timely medication approvals.
Requirements:
Experience in US Healthcare Prior Authorisation is preferred.
Knowledge of Cover-My-Meds and insurance authorisation processes.
Solid communication and follow-up skills.
Valuable documentation and attention to detail.
Ability to work in a fast-paced setting and meet turnaround times.