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Drug Prior Authorization

Drug Prior Authorization

Suma Soft

1 - 5 years

3 - 6 Lacs

pune

Posted:3 weeks ago| Platform:

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Skills Required

prior authorization denial management authorization ar calling rcm

Work Mode

Work from Office

Job Type

Full Time

Job Description

Role & responsibilities

Job Title: Drug Prior Authorization

Job Title

Location

Job Summary

Manage prior authorization process for treatments and medications.
Ensure timely approvals through effective communication with providers, insurers, and patients.
Handle on-call coordination to support smooth processing.

Key Responsibilities

Process and track prior authorization requests.
Review clinical documents for compliance and medical necessity.
Coordinate with insurance providers for approvals and appeal denials as needed.
Maintain detailed records of submissions, approvals, denials, and appeals.
Stay updated on drug formularies and insurance authorization policies.

Preferred candidate profile

Required Skills and Qualifications

Education
:

Any Graduate.

Experience
:

Minimum 1 year in prior authorizations, pharmacy, or healthcare insurance.
Experience with treatment protocols and medications

Communication
:

Excellent verbal and written communication skills.

Other Skills
:

Strong organizational and multitasking abilities.

Contact Details

Name: Sakshi Shah

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