Role & responsibilities
Process medication prior authorizations using CoverMyMeds and payer portals.
Review patient records, clinical documentation, and insurance requirements.
Follow up on pending, approved, and denied authorizations.
Coordinate patient referrals and track referral status through completion.
Communicate with insurance companies, provider offices, specialists, and patients.
Maintain accurate documentation in EHR systems and tracking tools.
Ensure HIPAA compliance and data confidentiality.
Preferred candidate profile
1+ year of experience in Prior Authorization, Referral Coordination, or Healthcare RCM.
Experience with CoverMyMeds, EHR systems, and payer portals.
Knowledge of medication authorization workflows and insurance processes.
Robust communication, organizational, and follow-up skills.
Familiarity with HIPAA and healthcare documentation standards.